Jennifer M Marcum
Individual provider Active NPI Pharmacist · Ulysses, KY
NPI 1003105669 · NPPES record last updated Apr 5, 2011
Key facts
- NPI
- 1003105669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 012903 (KY)
- Practice address
- 120 Cresley Branch Road
Ulysses, KY 41224 - Phone
- (606) 673-1161
- NPI assigned
- Apr 5, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012903 | KY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 012903 | KY | Yes |
Addresses
Primary practice location
120 Cresley Branch Road
Ulysses, KY 41224
Mailing address
120 Cresley Branch Road
Ulysses, KY 41224
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.