Provider Demographics
NPI:1518188085
Name:O'GRADY, JENNIFER A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:O'GRADY
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 1:6014 S 158TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2328
Mailing Address - Country:US
Mailing Address - Phone:402-210-3440
Mailing Address - Fax:
Practice Address - Street 1:6014 S 158TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-2328
Practice Address - Country:US
Practice Address - Phone:402-210-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist