Provider Demographics
NPI:1841401635
Name:WILLIAMS, JENNIFER N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:WILLIAMS
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 1:2423 GA HIGHWAY 21 N
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329-3832
Mailing Address - Country:US
Mailing Address - Phone:912-754-6591
Mailing Address - Fax:
Practice Address - Street 1:504 N LAUREL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-6814
Practice Address - Country:US
Practice Address - Phone:912-754-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist