Provider Demographics
NPI:1710158282
Name:NEWELL, JENNIFER (PHARMD, CDOE)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:PHARMD, CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4630
Mailing Address - Country:US
Mailing Address - Phone:401-722-0232
Mailing Address - Fax:
Practice Address - Street 1:2 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4630
Practice Address - Country:US
Practice Address - Phone:401-722-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist