Provider Demographics
NPI:1114546405
Name:OLOPAADE, JENNIE J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:J
Last Name:OLOPAADE
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 1:3012 FRANCISCAN DR APT 625
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2543
Mailing Address - Country:US
Mailing Address - Phone:251-599-9800
Mailing Address - Fax:
Practice Address - Street 1:3012 FRANCISCAN DR APT 625
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2543
Practice Address - Country:US
Practice Address - Phone:251-599-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64652183500000X
AL15474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist