Provider Demographics
NPI:1093311706
Name:BLEVINS, JENNIFER (PHARMD, RPH, BCGP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:PHARMD, RPH, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5591 BARNEY DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-3259
Mailing Address - Country:US
Mailing Address - Phone:419-302-6506
Mailing Address - Fax:
Practice Address - Street 1:4014 VENTURE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9600
Practice Address - Country:US
Practice Address - Phone:614-297-8244
Practice Address - Fax:502-434-6428
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032280671835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric