Provider Demographics
NPI:1538372263
Name:BOOK, JENNIFER A
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:BOOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10012 220TH ST
Mailing Address - Street 2:
Mailing Address - City:PANORA
Mailing Address - State:IA
Mailing Address - Zip Code:50216
Mailing Address - Country:US
Mailing Address - Phone:641-439-5333
Mailing Address - Fax:
Practice Address - Street 1:1725 JORDAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5876
Practice Address - Country:US
Practice Address - Phone:515-226-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist