Provider Demographics
NPI:1295021913
Name:DRIELING, JENA ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENA
Middle Name:ANN
Last Name:DRIELING
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 1:9715 W BRIARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1432
Mailing Address - Country:US
Mailing Address - Phone:402-720-2451
Mailing Address - Fax:
Practice Address - Street 1:13503 W CAMINO DEL SOL
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4439
Practice Address - Country:US
Practice Address - Phone:623-584-0501
Practice Address - Fax:623-546-5538
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018397183500000X
NE13585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist