Provider Demographics
NPI:1730515297
Name:DOBBINS, JESSICA MARI (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARI
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 POTTER RD
Mailing Address - Street 2:
Mailing Address - City:STALLINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-5990
Mailing Address - Country:US
Mailing Address - Phone:704-821-0411
Mailing Address - Fax:704-821-0495
Practice Address - Street 1:5455 POTTER RD
Practice Address - Street 2:
Practice Address - City:STALLINGS
Practice Address - State:NC
Practice Address - Zip Code:28104-5990
Practice Address - Country:US
Practice Address - Phone:704-821-0411
Practice Address - Fax:704-821-0495
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist