Provider Demographics
NPI:1801516240
Name:TEJEDA, JESSICA GARCIA (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:GARCIA
Last Name:TEJEDA
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 1:169 HIDDEN HILL CV
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-1008
Mailing Address - Country:US
Mailing Address - Phone:731-819-6514
Mailing Address - Fax:
Practice Address - Street 1:1601 W REELFOOT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5554
Practice Address - Country:US
Practice Address - Phone:731-885-6498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist