Individual
JESSICA LYNN SCHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1502 WOODLANE DR, WOODBURY, MN 55125-2221
(651) 735-9550
(651) 735-9322
Mailing address
1502 WOODLANE DR, WOODBURY, MN 55125-2221
(651) 735-9550
(651) 735-9322
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3133
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123023900
—
MN
01
—
3133
MINNESOTA STATE LICENSE
MN
01
—
410003154
MEDICARE PTAN
MN
01
—
973651062161
PREFERRED ONE
MN
Enumeration date
07/09/2008
Last updated
02/25/2016
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