Jessica Boutwell Valid NPI
Individual provider · Pharmacist · Brookhaven, MS
- NPI
- 1275138869
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- E09434 (MS)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2020-12-01
- Last updated
- 2020-12-01
Practice location
950 Brookway Blvd
Brookhaven, MS 39601-2644
(601) 833-8436