Provider Demographics
NPI:1659074409
Name:ABNEY, JACQUELINE A
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:A
Last Name:ABNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 AKINS CT
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-3207
Mailing Address - Country:US
Mailing Address - Phone:330-396-2597
Mailing Address - Fax:
Practice Address - Street 1:1403 WOOSTER RD W
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-7374
Practice Address - Country:US
Practice Address - Phone:330-706-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09217606183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician