Provider Demographics
NPI:1619318490
Name:STROUD, JILLIAN RACHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:RACHELLE
Last Name:STROUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 WEST 28TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-9675
Mailing Address - Country:US
Mailing Address - Phone:870-489-1612
Mailing Address - Fax:870-850-0177
Practice Address - Street 1:3006 WEST 28TH AVENUE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-9675
Practice Address - Country:US
Practice Address - Phone:870-489-1612
Practice Address - Fax:870-850-0177
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist