Provider Demographics
NPI:1912259789
Name:GILLESPIE, JEANN LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEANN
Middle Name:LEE
Last Name:GILLESPIE
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 1:10310 BRITTENFORD DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1858
Mailing Address - Country:US
Mailing Address - Phone:805-405-9566
Mailing Address - Fax:
Practice Address - Street 1:10310 BRITTENFORD DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-1858
Practice Address - Country:US
Practice Address - Phone:805-405-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022111841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist