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Individual

JENNIFER MAUNEY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
419 E MAIN ST, BURNSVILLE, NC 28714-3050
(828) 682-2104
(828) 682-4217
Mailing address
419 E MAIN ST, BURNSVILLE, NC 28714-3050
(828) 682-2104
(828) 682-4217

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2052
NC
152WP0200X
Pediatric Optometrist
2052
NC
152WV0400X
Vision Therapy Optometrist
2052
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
145FK
BCBS
NC
01
2388088
WELLCARE
05
5907709
NC
Enumeration date
04/04/2007
Last updated
12/30/2022
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