Jessica M Wiley, PHARMD.
Individual provider Active NPI Pharmacist · Taneytown, MD
NPI 1639645690 · NPPES record last updated Oct 17, 2018
Key facts
- NPI
- 1639645690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 25916 (MD)
- Practice address
- 116 Carnival Dr
Taneytown, MD 21787-2178 - Phone
- (443) 277-9460
- NPI assigned
- Oct 17, 2018
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 25916 | MD | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 25916 | MD | Yes |
Addresses
Primary practice location
116 Carnival Dr
Taneytown, MD 21787-2178
Mailing address
116 Carnival Dr
Taneytown, MD 21787-2414
Phone (443) 277-9460
Other providers in Taneytown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2018. 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.