Provider Demographics
NPI:1013951789
Name:WICK, JENNIFER ROSE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:WICK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IC VAMC PHARMACY
Mailing Address - Street 2:601 HWY 6 WEST
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246
Mailing Address - Country:US
Mailing Address - Phone:319-338-0581
Mailing Address - Fax:
Practice Address - Street 1:IC VAMC PHARMACY
Practice Address - Street 2:601 HWY 6 WEST
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246
Practice Address - Country:US
Practice Address - Phone:319-338-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31116331835P1200X
IA19679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy