Provider Demographics
NPI:1790124683
Name:WELLS, JENNY ALLISON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:ALLISON
Last Name:WELLS
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 1:15400 CHENAL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2016
Mailing Address - Country:US
Mailing Address - Phone:501-708-4320
Mailing Address - Fax:501-708-4315
Practice Address - Street 1:15400 CHENAL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2016
Practice Address - Country:US
Practice Address - Phone:501-708-4320
Practice Address - Fax:501-708-4315
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist