Provider Demographics
NPI:1013296631
Name:SELLERS, JILL ANDREA (BSPHARM, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:ANDREA
Last Name:SELLERS
Suffix:
Gender:F
Credentials:BSPHARM, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 E WILSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809-3407
Mailing Address - Country:US
Mailing Address - Phone:218-209-1514
Mailing Address - Fax:
Practice Address - Street 1:3650 E SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65809-2820
Practice Address - Country:US
Practice Address - Phone:417-889-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-13
Last Update Date:2011-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0436831835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist