Provider Demographics
NPI:1619402518
Name:WENTE, JESSICA PEARL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:PEARL
Last Name:WENTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:PEARL
Other - Last Name:BURKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4533 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4700
Mailing Address - Country:US
Mailing Address - Phone:419-471-9241
Mailing Address - Fax:419-471-9458
Practice Address - Street 1:4533 MONROE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4700
Practice Address - Country:US
Practice Address - Phone:419-471-9241
Practice Address - Fax:419-471-9458
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist