Provider Demographics
NPI:1689979742
Name:CREECH, JESSICA WILLEMS (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:WILLEMS
Last Name:CREECH
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 1:920 CLAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-9284
Mailing Address - Country:US
Mailing Address - Phone:704-425-7572
Mailing Address - Fax:
Practice Address - Street 1:245 E ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2719
Practice Address - Country:US
Practice Address - Phone:919-556-1900
Practice Address - Fax:919-556-1791
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist