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Individual

DR. JENNIFER MICHELLE POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3115 ACADEMY RD, DURHAM, NC 27707
(919) 493-7456
(919) 493-1718
Mailing address
3115 ACADEMY RD, DURHAM, NC 27707-2652
(919) 493-7456
(919) 493-1718

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2043
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093V0
BCBS PIN
NC
05
5905982
NC
Enumeration date
01/10/2007
Last updated
05/21/2018
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