Provider Demographics
NPI:1780784421
Name:BRANSTETTER, JENNIFER D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:BRANSTETTER
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 1:605 S ARCHUSA AVE
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39355-2331
Mailing Address - Country:US
Mailing Address - Phone:601-776-6925
Mailing Address - Fax:601-776-7156
Practice Address - Street 1:605 S ARCHUSA AVE
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:MS
Practice Address - Zip Code:39355-2331
Practice Address - Country:US
Practice Address - Phone:601-776-6925
Practice Address - Fax:601-776-7156
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist