Individual
DR. JESSICA RAVEN CALLAGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
134 VENTURE LN, STATESVILLE, NC 28625-2740
(704) 380-6134
Mailing address
134 VENTURE LN, STATESVILLE, NC 28625-2740
(704) 380-6134
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
30105
NC
183500000X
Pharmacist
Primary
RPH027466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH027466
RPH027466
GA
Enumeration date
07/13/2015
Last updated
07/27/2023
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