Provider Demographics
NPI:1912386145
Name:OBENRADER, JENNIFER (PHARMD, CDCES)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:OBENRADER
Suffix:
Gender:F
Credentials:PHARMD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 NORTHERN PIKE STE 350
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2171
Mailing Address - Country:US
Mailing Address - Phone:412-380-2800
Mailing Address - Fax:412-457-1234
Practice Address - Street 1:3824 NORTHERN PIKE STE 350
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2171
Practice Address - Country:US
Practice Address - Phone:412-380-2800
Practice Address - Fax:412-457-1234
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045386R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist