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Individual
VANESSA JEAN EWING
Active
Individual
VANESSA JEAN EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003453A
IN
152W00000X
Optometrist
Primary
OPT33920TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200908990
—
IN
05
—
7100100450
—
KY
Enumeration date
07/30/2007
Last updated
07/10/2019
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