Provider Demographics
NPI:1568833416
Name:ULRICHS, JENNIFER STREETER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:STREETER
Last Name:ULRICHS
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 1:2620 LAKE ELMO DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3913
Mailing Address - Country:US
Mailing Address - Phone:406-671-1927
Mailing Address - Fax:
Practice Address - Street 1:2620 LAKE ELMO DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3913
Practice Address - Country:US
Practice Address - Phone:406-671-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist