Jessica Abdou, PHARMD
Individual provider Active NPI Pharmacist · Grand Rapids, MI
NPI 1851992473 · NPPES record last updated Nov 2, 2020
Key facts
- NPI
- 1851992473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302412092 (MI)
- Practice address
- 5859 28TH St SE
Grand Rapids, MI 49546-6905 - Phone
- (616) 949-9892
- NPI assigned
- Nov 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 5302412092 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302412092 | MI | Yes |
Addresses
Primary practice location
5859 28TH St SE
Grand Rapids, MI 49546-6905
Mailing address
1660 Ridgewood Ave SE
Grand Rapids, MI 49506-5064
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2020. 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.