Provider Demographics
NPI:1235256967
Name:ANDRESS, JESSICA BAILEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BAILEY
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10219 SIOUX RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1134
Mailing Address - Country:US
Mailing Address - Phone:804-327-0085
Mailing Address - Fax:
Practice Address - Street 1:11361 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4715
Practice Address - Country:US
Practice Address - Phone:804-379-9536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist