Individual
JENNIFER SIPOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
800 NE 10TH ST STE 3001, OKLAHOMA CITY, OK 73104-5418
(405) 271-2604
Mailing address
1902 SHADOW LAKE DR, EDMOND, OK 73025-1711
(405) 503-0901
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
13285
OK
1835P1200X
Pharmacotherapy Pharmacist
13285
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13285
OKLAHOMA STATE BOARD OF PHARMACY LICENSE
OK
Enumeration date
04/30/2019
Last updated
04/30/2019
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