Provider Demographics
NPI:1932552692
Name:SINGLETON, JERICA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JERICA
Middle Name:MICHELLE
Last Name:SINGLETON
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 1:6749 BREEZY PALM DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-8811
Mailing Address - Country:US
Mailing Address - Phone:352-219-3666
Mailing Address - Fax:
Practice Address - Street 1:1920 ELM ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3641
Practice Address - Country:US
Practice Address - Phone:563-589-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist