Jessica Elizabeth Fennelly, PharmD
Pharmacist, Ambulatory Care in Canton, MI. Individual provider (NPI-1).
NPI number1235655432
StatusActive
Last updated in NPPESFeb 6, 2018
Details
- NPI
- 1235655432
- Entity type
- Individual (NPI-1)
- Name
- Jessica Elizabeth Fennelly
- Credential
- PharmD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 18, 2017
- Last updated
- Feb 6, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P2201X | Pharmacist, Ambulatory Care | 5302040848 | MI | Yes |
Practice location
1051 N Canton Center RdCanton, MI 48187-5097
Phone 734-844-5400
Mailing address
1051 N Canton Center RdCanton, MI 48187-5097
Phone 734-844-5400
Is something wrong?
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Other Ambulatory Care Pharmacist providers in Canton, MI
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