Provider Demographics
NPI:1477223147
Name:PURPURA, JASMINE C (PHARM D)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:C
Last Name:PURPURA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WILSON AVE SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5684
Mailing Address - Country:US
Mailing Address - Phone:319-362-3649
Mailing Address - Fax:
Practice Address - Street 1:20 WILSON AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5684
Practice Address - Country:US
Practice Address - Phone:319-362-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist