Provider Demographics
NPI:1255706941
Name:LANGDON, JESSICA TEGAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:TEGAN
Last Name:LANGDON
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 1:2817 REILLY ST
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-7324
Mailing Address - Country:US
Mailing Address - Phone:910-643-9426
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCK MERRITT AVENUE PHARMACY DEPARTMENT
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-7324
Practice Address - Country:US
Practice Address - Phone:910-907-7508
Practice Address - Fax:910-907-7956
Is Sole Proprietor?:No
Enumeration Date:2015-12-06
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24377183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist