Provider Demographics
NPI:1447082565
Name:JESSEN, AUBREY DAYLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:DAYLE
Last Name:JESSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:DAYLE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26684 LILAC AVE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:MO
Mailing Address - Zip Code:64640-8220
Mailing Address - Country:US
Mailing Address - Phone:660-605-1636
Mailing Address - Fax:
Practice Address - Street 1:504 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-3038
Practice Address - Country:US
Practice Address - Phone:660-240-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023029187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist