Provider Demographics
NPI:1982871737
Name:O'KELL, JESSICA ELLEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELLEN
Last Name:O'KELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ELLEN
Other - Last Name:SYKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1972
Mailing Address - Country:US
Mailing Address - Phone:716-775-1600
Mailing Address - Fax:
Practice Address - Street 1:2320 GRAND ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-3113
Practice Address - Country:US
Practice Address - Phone:716-775-0691
Practice Address - Fax:716-775-0697
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY49309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist