Individual
DR. JENNIFER L SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
379
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS10819
CONTROLLED SUBSTANCE
NV
Enumeration date
10/24/2006
Last updated
03/07/2023
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