Provider Demographics
NPI:1134416134
Name:CLEVELAND, JENNIFER JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JOSEPH
Last Name:CLEVELAND
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 1:431 PARK VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3849
Mailing Address - Country:US
Mailing Address - Phone:865-730-4200
Mailing Address - Fax:865-730-4201
Practice Address - Street 1:431 PARK VILLAGE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3849
Practice Address - Country:US
Practice Address - Phone:865-730-4200
Practice Address - Fax:865-730-4201
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist