Provider Demographics
NPI:1356653851
Name:YERKES, JESSICA ROSE (RPH)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROSE
Last Name:YERKES
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 1:2073 WAGON WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8033
Mailing Address - Country:US
Mailing Address - Phone:513-505-4696
Mailing Address - Fax:
Practice Address - Street 1:1505 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1079
Practice Address - Country:US
Practice Address - Phone:513-737-0894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326625183500000X
KY013010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist