Provider Demographics
NPI:1467731372
Name:WHITWORTH, JANE ELLEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ELLEN
Last Name:WHITWORTH
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 1:5151 PFEIFFER RD STE 350
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4861
Mailing Address - Country:US
Mailing Address - Phone:833-358-2113
Mailing Address - Fax:844-243-3856
Practice Address - Street 1:5151 PFEIFFER RD STE 350
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-4861
Practice Address - Country:US
Practice Address - Phone:949-491-6583
Practice Address - Fax:844-243-3856
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No183500000XPharmacy Service ProvidersPharmacist