Provider Demographics
NPI:1184039125
Name:CUPAC, JESSICA (PHARMD, BCOP)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:CUPAC
Suffix:
Gender:F
Credentials:PHARMD, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST # H110
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-7001
Mailing Address - Country:US
Mailing Address - Phone:606-344-5481
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE STREET H110
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-28
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017081183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist