Active NPI
Jennifer Nan Wilson Page, RPH
- Pharmacist
- Southlake, TX
National Provider Identifier
1427389592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37853
- Practice address
- 705 Venice Ave
Southlake, TX 76092-8241 - Phone
- (817) 431-5305
- Fax
- (817) 431-5508
- NPI assigned
- Jan 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 37853 | TX | Primary |
Addresses
Primary practice location
705 Venice Ave
Southlake, TX 76092-8241
Mailing address
705 Venice Ave
Southlake, TX 76092-8241
Phone (817) 431-5305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37853 | TX | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1427389592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 VENICE AVE",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760928241",
"telephone_number": "817-431-5305",
"fax_number": "817-431-5508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 VENICE AVE",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760928241",
"telephone_number": "817-431-5305",
"fax_number": "817-431-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "JENNIFER",
"middle_name": "NAN WILSON",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-28",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "37853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.