Individual
JENNIFER FISHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3185 W STATE ST STE 2010, BRISTOL, TN 37620-1600
(423) 968-7555
Mailing address
2010 BREMO RD STE 128A, RICHMOND, VA 23226-2444
(877) 969-0392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1791
NC
152W00000X
Optometrist
Primary
3779
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093A7
BLUE CROSS PROVIDER ID
NC
01
—
2256806
UNITED HEALTH CARE ID
NC
05
—
89093A7
—
NC
01
—
A5231
MEDCOST PROVIDER ID
NC
Enumeration date
08/03/2005
Last updated
11/22/2022
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