Provider Demographics
NPI:1770130197
Name:STRAND, JENNI DEANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNI
Middle Name:DEANNE
Last Name:STRAND
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 1:3349 W SHAW BUTTE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2205
Mailing Address - Country:US
Mailing Address - Phone:602-561-1805
Mailing Address - Fax:
Practice Address - Street 1:4410 W CACTUS RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-2338
Practice Address - Country:US
Practice Address - Phone:602-938-5087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist