Provider Demographics
NPI:1427208131
Name:SCOTT, JESSICA STROUPE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:STROUPE
Last Name:SCOTT
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 1:114 E LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3662
Mailing Address - Country:US
Mailing Address - Phone:336-786-2177
Mailing Address - Fax:336-786-1556
Practice Address - Street 1:114 E LEBANON ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-3662
Practice Address - Country:US
Practice Address - Phone:336-786-2177
Practice Address - Fax:336-786-1556
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist