Provider Demographics
NPI:1730623265
Name:MULCARE, JESSICA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:MULCARE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:ROBOTNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 COUNTY ROAD B W
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1931
Mailing Address - Country:US
Mailing Address - Phone:651-489-6271
Mailing Address - Fax:651-487-0966
Practice Address - Street 1:100 COUNTY ROAD B W
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-1931
Practice Address - Country:US
Practice Address - Phone:651-489-6271
Practice Address - Fax:651-487-0966
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist