Provider Demographics
NPI:1740943901
Name:ERKENS, JILL SMITH (BPHARM)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:SMITH
Last Name:ERKENS
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26919 N 7TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-6387
Mailing Address - Country:US
Mailing Address - Phone:614-327-1742
Mailing Address - Fax:
Practice Address - Street 1:1850 W RIO SALADO PKWY STE 211
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5713
Practice Address - Country:US
Practice Address - Phone:602-883-3209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist