Provider Demographics
NPI:1083126288
Name:MARCINEK, JENNIFER LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:MARCINEK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 CHURCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2256
Mailing Address - Country:US
Mailing Address - Phone:615-645-4790
Mailing Address - Fax:615-645-4791
Practice Address - Street 1:1700 NW 80TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9177
Practice Address - Country:US
Practice Address - Phone:352-333-2525
Practice Address - Fax:888-276-7948
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS51705OtherBOARD OF PHARMACY
TN38322OtherBOARD OF PHARMACY