Provider Demographics
NPI:1245524412
Name:STABLES, JENNIFER (RPH)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:STABLES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 RIVER BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064
Mailing Address - Country:US
Mailing Address - Phone:850-687-3357
Mailing Address - Fax:615-329-9382
Practice Address - Street 1:1215 21ST AVE SOUTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-352-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225214183500000X
TN00032470183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist