Healthcare Provider Details

I. General information

NPI: 1295132520
Provider Name (Legal Business Name): DR. JINGYA JEANNE CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 DURHAM RD
ROXBORO NC
27573-6178
US

IV. Provider business mailing address

2858 DURHAM RD
ROXBORO NC
27573-6178
US

V. Phone/Fax

Practice location:
  • Phone: 336-599-0246
  • Fax: 336-597-3356
Mailing address:
  • Phone: 336-599-0246
  • Fax: 336-597-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2406
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: