Provider Demographics
NPI:1740883347
Name:SHOWN, JENNIFER RHEA (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RHEA
Last Name:SHOWN
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:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-0918
Mailing Address - Country:US
Mailing Address - Phone:270-882-2222
Mailing Address - Fax:270-882-6337
Practice Address - Street 1:289 MAIN ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-9151
Practice Address - Country:US
Practice Address - Phone:270-882-2222
Practice Address - Fax:270-882-6337
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist