Provider Demographics
NPI:1871376087
Name:HANDSAKER, JENNIFER KAY (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:HANDSAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WILLSON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3580
Mailing Address - Country:US
Mailing Address - Phone:406-587-4332
Mailing Address - Fax:406-587-8125
Practice Address - Street 1:1720 STAGECOACH TRAIL RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:MT
Practice Address - Zip Code:59741-8272
Practice Address - Country:US
Practice Address - Phone:406-581-4804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-4233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist