Provider Demographics
NPI:1922047232
Name:ENCALADE, JACQUELINE MARIE (DPH)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MARIE
Last Name:ENCALADE
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 SNICKERS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8707
Mailing Address - Country:US
Mailing Address - Phone:901-373-3230
Mailing Address - Fax:
Practice Address - Street 1:5366 WINCHESTER ROAD
Practice Address - Street 2:CHRIST COMMUNITY HEALTH SERVICES
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4505
Practice Address - Country:US
Practice Address - Phone:901-271-6170
Practice Address - Fax:901-271-6180
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist