Provider Demographics
NPI:1598377152
Name:JANSEN, SEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:JANSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-7006
Mailing Address - Country:US
Mailing Address - Phone:865-428-3954
Mailing Address - Fax:865-428-3071
Practice Address - Street 1:1840 PARKWAY
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-7006
Practice Address - Country:US
Practice Address - Phone:865-428-3954
Practice Address - Fax:865-428-3071
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist