Provider Demographics
NPI:1730719022
Name:JENNINGS, KAREN SUZANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUZANNE
Last Name:JENNINGS
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 1:42929 CARDINAL WAY
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3655
Mailing Address - Country:US
Mailing Address - Phone:248-890-8488
Mailing Address - Fax:
Practice Address - Street 1:10915 BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111
Practice Address - Country:US
Practice Address - Phone:734-697-4000
Practice Address - Fax:734-697-0070
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist