Provider Demographics
NPI:1891377024
Name:JESSEE-DINGUS, BOBBI JO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BOBBI
Middle Name:JO
Last Name:JESSEE-DINGUS
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 1:555 DINGUS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CASTLEWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24224-4064
Mailing Address - Country:US
Mailing Address - Phone:276-202-5170
Mailing Address - Fax:
Practice Address - Street 1:13320 GOVERNOR G C PEERY HWY
Practice Address - Street 2:
Practice Address - City:POUNDING MILL
Practice Address - State:VA
Practice Address - Zip Code:24637-4207
Practice Address - Country:US
Practice Address - Phone:276-596-9116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022181051835P0018X
TN425931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN42593OtherBOARD OF PHARMACY
VA0202218105OtherBOARD OF PHARMACY