Provider Demographics
NPI:1477620607
Name:VOGELSANG, JAMIE LYNN (RPH)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LYNN
Last Name:VOGELSANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 BAYSHORE TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5524
Mailing Address - Country:US
Mailing Address - Phone:813-839-3920
Mailing Address - Fax:
Practice Address - Street 1:2846 BAYSHORE TRAILS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-5524
Practice Address - Country:US
Practice Address - Phone:813-839-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist