Provider Demographics
NPI:1376988436
Name:AINSWORTH, JENNIFER CLARKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CLARKE
Last Name:AINSWORTH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:MACKENZIE
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:708 CASTILE CT APT C
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-6043
Mailing Address - Country:US
Mailing Address - Phone:804-912-7632
Mailing Address - Fax:844-965-9043
Practice Address - Street 1:708 CASTILE COURT APARTMENT C
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-6043
Practice Address - Country:US
Practice Address - Phone:804-912-7632
Practice Address - Fax:844-965-9043
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA020225803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist