Provider Demographics
NPI:1144998386
Name:WILCOX, JENNA CALDWELL (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:CALDWELL
Last Name:WILCOX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:AILEEN
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 WESTRIDGE MARKET PL
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9174
Mailing Address - Country:US
Mailing Address - Phone:828-257-4433
Mailing Address - Fax:
Practice Address - Street 1:25 WESTRIDGE MARKET PL
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9174
Practice Address - Country:US
Practice Address - Phone:828-257-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30788183500000X
NC7004491835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist