Reagan Jacobs
Individual provider Active NPI Pharmacist · Ripley, TN
NPI 1811643182 · NPPES record last updated Feb 25, 2022
Key facts
- NPI
- 1811643182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0000045439 (TN)
- Practice address
- 628 Highway 51 N
Ripley, TN 38063-5904 - Phone
- (731) 635-8904
- NPI assigned
- Feb 25, 2022
- 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 |
|---|---|---|---|
| 0000045439 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0000045439 | TN | Yes |
Addresses
Primary practice location
628 Highway 51 N
Ripley, TN 38063-5904
Mailing address
98 Okelley CV
Atoka, TN 38004-7481
Phone (731) 612-0734
Other providers in Ripley, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2022. 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.