Provider Demographics
NPI:1861808404
Name:HAGA, JESSICA LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:HAGA
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 RIDGE FARM PL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4782
Mailing Address - Country:US
Mailing Address - Phone:615-260-2513
Mailing Address - Fax:
Practice Address - Street 1:3458 DICKERSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2511
Practice Address - Country:US
Practice Address - Phone:615-873-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist