Jennifer Bosgra, PHARMD D

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Chinle, AZ

NPI 1508102096 · NPPES record last updated Jan 2, 2013

Key facts

NPI
1508102096
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
13426 (AZ)
Practice address
191 Hospital Dr
Chinle, AZ 86503
Phone
(928) 674-7042
NPI assigned
Jan 2, 2013
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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
13426AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 13426 AZ Yes

Addresses

Primary practice location

191 Hospital Dr
Chinle, AZ 86503

Mailing address

6576 White Pine Dr
Lakeside, AZ 85929-5055
Phone (928) 595-3013

Other providers in Chinle, AZ

All providers in Chinle, AZ · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Arizona

Sources for this page

Verify at the official NPI Registry.