Provider Demographics
NPI:1790317568
Name:BEZANT, JESSICA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:BEZANT
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 1:537 GLENMONT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3258
Mailing Address - Country:US
Mailing Address - Phone:614-286-1510
Mailing Address - Fax:
Practice Address - Street 1:930 N WAGGONER RD
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7910
Practice Address - Country:US
Practice Address - Phone:614-490-3037
Practice Address - Fax:614-490-3039
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033220251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist