Individual
ANNELLE GLEE MAYGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
12333T
CA
152W00000X
Optometrist
2964T
OR
152W00000X
Optometrist
Primary
297
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023212
—
AK
01
—
OPTT297
STATE OF ALASKA
AK
Enumeration date
05/23/2005
Last updated
11/07/2022
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