Provider Demographics
NPI:1407064629
Name:SANDERS, JENNIFER ANN (PHARMD,MBA,BS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PHARMD,MBA,BS
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CLYDESDALE DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4825
Mailing Address - Country:US
Mailing Address - Phone:540-869-5359
Mailing Address - Fax:
Practice Address - Street 1:410 FAIRFAX PIKE
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-2969
Practice Address - Country:US
Practice Address - Phone:540-869-2212
Practice Address - Fax:540-868-2439
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205753183500000X
MD16517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist