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Individual

JESSICA PROCIV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
6938 ELM VALLEY DR STE 101, KALAMAZOO, MI 49009-7438
(269) 552-4167
(269) 552-4216
Mailing address
3928 N ROSEBUD DR SE, APT #8, KENTWOOD, MI 49512-9404

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302037973
MI
1835P2201X
Ambulatory Care Pharmacist
5302037973
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302037973
STATE OF MICHIGAN BOARD OF PHARMACY
MI
Enumeration date
09/28/2011
Last updated
12/17/2018
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