Provider Demographics
NPI:1205828027
Name:BURKHART, JENA IVEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENA
Middle Name:IVEY
Last Name:BURKHART
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 1:104 TEAGAN CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4372
Mailing Address - Country:US
Mailing Address - Phone:919-966-2626
Mailing Address - Fax:
Practice Address - Street 1:CB 7574 BEARD HALL 115H
Practice Address - Street 2:SCHOOL OF PHARMACY
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-2626
Practice Address - Fax:919-962-0644
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172321835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy