Provider Demographics
NPI:1083961437
Name:SPENCE, JESSICA MILLS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MILLS
Last Name:SPENCE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:802 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2357
Mailing Address - Country:US
Mailing Address - Phone:302-761-1700
Mailing Address - Fax:302-761-1706
Practice Address - Street 1:802 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2357
Practice Address - Country:US
Practice Address - Phone:302-761-1700
Practice Address - Fax:302-761-1706
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-04
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10004295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist