Provider Demographics
NPI:1730468562
Name:MEADE, JESSICA TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:TAYLOR
Last Name:MEADE
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 1:22302 ROSE GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6826
Mailing Address - Country:US
Mailing Address - Phone:252-531-6524
Mailing Address - Fax:
Practice Address - Street 1:22302 ROSE GARDEN LANE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6826
Practice Address - Country:US
Practice Address - Phone:252-531-6524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist