Provider Demographics
NPI:1700196185
Name:STOIKO, JESSICA ELYSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ELYSE
Last Name:STOIKO
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 1:82 E HILL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3022
Mailing Address - Country:US
Mailing Address - Phone:702-343-3097
Mailing Address - Fax:
Practice Address - Street 1:1101 FOREST RETREAT RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2272
Practice Address - Country:US
Practice Address - Phone:615-348-3258
Practice Address - Fax:615-348-3249
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22078183500000X
TN400111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist