Provider Demographics
NPI:1578162756
Name:SORGENFREI, JENNA ELIZABETH (PHARMD, MSPS, BCCCP)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:ELIZABETH
Last Name:SORGENFREI
Suffix:
Gender:F
Credentials:PHARMD, MSPS, BCCCP
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:ELIZABETH
Other - Last Name:GRAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 WELLWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9850
Mailing Address - Country:US
Mailing Address - Phone:315-571-6589
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-5288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28820183500000X
SC42479183500000X, 1835C0205X
FLPS62452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No183500000XPharmacy Service ProvidersPharmacist