Provider Demographics
NPI:1679915227
Name:JAMES, JESSICA NICOLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:JAMES
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 1:2440 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2123
Mailing Address - Country:US
Mailing Address - Phone:502-459-3248
Mailing Address - Fax:502-458-3502
Practice Address - Street 1:2440 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2123
Practice Address - Country:US
Practice Address - Phone:502-459-3248
Practice Address - Fax:502-458-3502
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist