Individual provider · Type 1 NPI

Tracie Marie Jackson, RPH

Pharmacist · Fenton, MO

NPI number 1891617387 Active

Practice location

1329 Horan Dr
Fenton, MO 63026-1939

Mailing address

16349 Centerpointe Dr
Wildwood, MO 63040-1602

Specialties and licenses

TaxonomyCodeLicense
Pharmacist 183500000X051288965 (IL)
Pharmacist Primary 183500000X2006005456 (MO)

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…

4 other providers at this address

Other pharmacist providers in Fenton

See all in Fenton →

About NPI 1891617387

Tracie Marie Jackson, RPH's National Provider Identifier is 1891617387, issued on Jul 28, 2026. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Fenton, MO. The record was last updated on Jul 28, 2026.