Provider Demographics
NPI:1093184285
Name:ABERNATHY, JENNIFER CHIAWEI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHIAWEI
Last Name:ABERNATHY
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 1:8011 HARPER DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1054
Mailing Address - Country:US
Mailing Address - Phone:505-858-3134
Mailing Address - Fax:
Practice Address - Street 1:8011 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1054
Practice Address - Country:US
Practice Address - Phone:505-858-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60613865183500000X
AK108585183500000X
NMRP00008437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist