Provider Demographics
NPI:1871878066
Name:FERRY, JENNIFER M (RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:FERRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 N 191ST STREET CIR W
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-9720
Mailing Address - Country:US
Mailing Address - Phone:316-796-1545
Mailing Address - Fax:
Practice Address - Street 1:710 N WEST ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1213
Practice Address - Country:US
Practice Address - Phone:316-943-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist