Individual
ANNALISE DIANE JENCSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
417 FELCH ST, ANN ARBOR, MI 48103-3201
(419) 277-1539
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302040243
MI
183500000X
Pharmacist
PH100000547
DC
183500000X
Pharmacist
RPH.03328751-3
OH
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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