Provider Demographics
NPI:1295899599
Name:WILLIAMS, JENNIFER BLOUNT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BLOUNT
Last Name:WILLIAMS
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 1:181 SCHOONER LANDING DR
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1743
Mailing Address - Country:US
Mailing Address - Phone:252-482-8985
Mailing Address - Fax:
Practice Address - Street 1:323 S BROAD ST
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1933
Practice Address - Country:US
Practice Address - Phone:252-793-1175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist