Provider Demographics
NPI:1801827282
Name:BEAN, JENNIFER ROSE (RPH,PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROSE
Last Name:BEAN
Suffix:
Gender:F
Credentials:RPH,PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ZORN AVE # 119
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1433
Mailing Address - Country:US
Mailing Address - Phone:615-410-8003
Mailing Address - Fax:
Practice Address - Street 1:800 ZORN AVE # 119
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1433
Practice Address - Country:US
Practice Address - Phone:615-410-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN217981835P1300X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist