Individual
DR. LAURA JEAN NENNIG I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2012017385
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48739022
BLUE CROSS BLUE SHIELD OF KC
MO
01
—
P01814216
RAILROAD MEDICARE
MO
Enumeration date
06/18/2012
Last updated
10/12/2020
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