Provider Demographics
NPI:1750875811
Name:GARCIA, JENNFER LYNN (BS OF PHARMACY, RPH)
Entity type:Individual
Prefix:
First Name:JENNFER
Middle Name:LYNN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BS OF PHARMACY, RPH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HENDRIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1404 NW ANGEL FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3450
Mailing Address - Country:US
Mailing Address - Phone:941-276-7222
Mailing Address - Fax:
Practice Address - Street 1:702 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6209
Practice Address - Country:US
Practice Address - Phone:407-913-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist