Provider Demographics
NPI:1184162497
Name:JARVIS, ESTHER (PHARMD, RPH, CDCES)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:JARVIS
Suffix:
Gender:F
Credentials:PHARMD, RPH, CDCES
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 341
Mailing Address - Street 2:
Mailing Address - City:KINNEAR
Mailing Address - State:WY
Mailing Address - Zip Code:82516-0341
Mailing Address - Country:US
Mailing Address - Phone:307-335-5983
Mailing Address - Fax:307-332-0304
Practice Address - Street 1:29 BLACK COAL DRIVE
Practice Address - Street 2:
Practice Address - City:FORT WASHAKIE
Practice Address - State:WY
Practice Address - Zip Code:82516
Practice Address - Country:US
Practice Address - Phone:307-335-5983
Practice Address - Fax:307-332-0304
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3282183500000X, 1835P2201X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care