Provider Demographics
NPI:1649823071
Name:JENNINGS, COURTNEY D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:D
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:D
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2451 CUMBERLAND PKWY SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 TECHNOLOGY CT SE STE B
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5201
Practice Address - Country:US
Practice Address - Phone:866-437-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist