Provider Demographics
NPI:1770943870
Name:PRESCOTT, JENNA L (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:L
Last Name:PRESCOTT
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 1:121 SE 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603
Mailing Address - Country:US
Mailing Address - Phone:877-232-4601
Mailing Address - Fax:877-234-1412
Practice Address - Street 1:121 SE 6TH STREET
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603
Practice Address - Country:US
Practice Address - Phone:877-232-4601
Practice Address - Fax:877-234-1412
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist