Individual provider · Type 1 NPI

Raven Natasha Jordan, PharmD

Pharmacist · Fayetteville, GA

NPI number 1679177240 Active

Practice location

107 Pavilion Pkwy
Fayetteville, GA 30214-4098

Call (770) 371-1200 Map

Fax (678) 734-9931

Mailing address

5940 Catawba Way
Atlanta, GA 30349-1559

Specialties and licenses

TaxonomyCodeLicense
Pharmacist Primary 183500000XRPH031159 (GA)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1679177240

Raven Natasha Jordan, PharmD's National Provider Identifier is 1679177240, issued on Nov 24, 2020. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Fayetteville, GA. The record was last updated on Nov 24, 2020.