Provider Demographics
NPI:1790026102
Name:O'CONNOR, JENNIFER SHERRY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SHERRY
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WALMART BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5248
Mailing Address - Country:US
Mailing Address - Phone:603-598-6533
Mailing Address - Fax:603-598-6515
Practice Address - Street 1:7 WALMART BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-5248
Practice Address - Country:US
Practice Address - Phone:603-598-6533
Practice Address - Fax:603-598-6515
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3235183500000X
MA24691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH3235OtherPHARMACIST LICENSE