Provider Demographics
NPI:1386012953
Name:JENNISON, MEGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:JENNISON
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:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04441-0530
Mailing Address - Country:US
Mailing Address - Phone:207-695-2921
Mailing Address - Fax:207-695-3449
Practice Address - Street 1:10 PRITHAM AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:ME
Practice Address - Zip Code:04441-3030
Practice Address - Country:US
Practice Address - Phone:207-695-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-12
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR45362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist