Provider Demographics
NPI:1548250764
Name:MAY, JACQUELYN ELIZABETH (BSPHARM)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:ELIZABETH
Last Name:MAY
Suffix:
Gender:F
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5222
Mailing Address - Country:US
Mailing Address - Phone:907-562-2138
Mailing Address - Fax:907-561-0752
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5222
Practice Address - Country:US
Practice Address - Phone:907-562-2138
Practice Address - Fax:907-561-0752
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist