Kandice Dawn Jeske, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

R-13771 Issued in OK

Practice address

Walgreens Pharmacy #5530
929 W Owen K Garriott Rd
Enid, OK 73701

Phone

(580) 237-3151

NPI assigned

Feb 2, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Enid, OK
  • NPI 1881609857
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1477144368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 CROSSFIELD DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730251237",
            "telephone_number": "405-863-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALGREENS PHARMACY #5530",
            "address_2": "929 W OWEN K GARRIOTT RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "73701",
            "telephone_number": "580-237-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKE",
        "first_name": "KANDICE",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "R-13771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Lee Jantzen, MA, LADC
• Dwayne Lee Janzen, D. O.
• Kimberley Jo Jaques, PHARMACIST
• Joey Wade Jeane
• Amy Brooke Jernigan, L.P.C
• John a. Thomas DDS
• John C Ogle DO PC
• John W Ronck MD PLLC
• Casey J Johnson, CRNA
• Ronald Stuart Johnson, PH.D.

• Pharmacist in Enid, OK
• Providers in Enid, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.