Provider Demographics
NPI:1386833952
Name:TAYLOR, JENNIFER PETERSON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:PETERSON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 FULTON ST # 152
Mailing Address - Street 2:HSR&D, BLDG 16, RM 70
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3875
Mailing Address - Country:US
Mailing Address - Phone:919-286-0411
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST # 152
Practice Address - Street 2:HSR&D, BLDG 16, RM 70
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist