Provider Demographics
NPI:1508816026
Name:COVINGTON, JESSICA J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:J
Last Name:COVINGTON
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 1:2921 DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2445
Mailing Address - Country:US
Mailing Address - Phone:502-821-4166
Mailing Address - Fax:
Practice Address - Street 1:2921 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2445
Practice Address - Country:US
Practice Address - Phone:502-821-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist