Provider Demographics
NPI:1972271914
Name:ARELLANO, JASMINE JARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:JARA
Last Name:ARELLANO
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:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-0070
Mailing Address - Country:US
Mailing Address - Phone:931-967-2777
Mailing Address - Fax:
Practice Address - Street 1:1201 DINAH SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1107
Practice Address - Country:US
Practice Address - Phone:931-967-2777
Practice Address - Fax:931-967-1264
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist