Provider Demographics
NPI:1548146616
Name:ELDEN, JENNIFER A (PHARMD, CPP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:ELDEN
Suffix:
Gender:F
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PARK DR STE 550
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0947
Mailing Address - Country:US
Mailing Address - Phone:704-403-1307
Mailing Address - Fax:704-403-1090
Practice Address - Street 1:200 MEDICAL PARK DR STE 550
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0947
Practice Address - Country:US
Practice Address - Phone:704-403-1307
Practice Address - Fax:704-403-1090
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist