Provider Demographics
NPI:1659890390
Name:ABERNATHY, JENNIFER ALEXANDRA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ALEXANDRA
Last Name:ABERNATHY
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 1:1801 WHETSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5199
Mailing Address - Country:US
Mailing Address - Phone:410-528-1244
Mailing Address - Fax:410-528-9293
Practice Address - Street 1:1801 WHETSTONE WAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5199
Practice Address - Country:US
Practice Address - Phone:410-528-1244
Practice Address - Fax:410-528-9293
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist