Provider Demographics
NPI:1558631382
Name:JEAN-BAPTISTE, TESSA (RPH)
Entity Type:Individual
Prefix:DR
First Name:TESSA
Middle Name:
Last Name:JEAN-BAPTISTE
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 1:2509 POTOMAC HUNT LN
Mailing Address - Street 2:APT 2 A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1500
Mailing Address - Country:US
Mailing Address - Phone:786-525-6550
Mailing Address - Fax:
Practice Address - Street 1:2509 POTOMAC HUNT LN
Practice Address - Street 2:APT 2 A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1500
Practice Address - Country:US
Practice Address - Phone:786-525-6550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist