Provider Demographics
NPI:1437261286
Name:STYBA, JENNIFER ANN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:STYBA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-5098
Mailing Address - Fax:612-727-5996
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-5098
Practice Address - Fax:612-727-5996
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117039-5183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist