Provider Demographics
NPI:1912337460
Name:SORBEL, JESSICA (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:SORBEL
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:GRAVATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1313 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-2900
Mailing Address - Country:US
Mailing Address - Phone:406-222-7332
Mailing Address - Fax:406-222-7370
Practice Address - Street 1:1313 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2900
Practice Address - Country:US
Practice Address - Phone:406-222-7332
Practice Address - Fax:406-222-7370
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist