Provider Demographics
NPI:1629859764
Name:HALL-PREAR, JANNEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANNEL
Middle Name:
Last Name:HALL-PREAR
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 1:4426 VENTURA WAY APT M
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-3156
Mailing Address - Country:US
Mailing Address - Phone:443-596-1567
Mailing Address - Fax:
Practice Address - Street 1:403 CONSTANT FRIENDSHIP BLVD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-2566
Practice Address - Country:US
Practice Address - Phone:410-670-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0015811183500000X
MD29181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist