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General NPI Number Information
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NPI Number | 1033146964
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Entity Type | Individual
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Provider Name | JENNIFER M WERRELL OD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 8333 N. DAVIS HIGHWAY WEST FLORDIA MEDICAL CENTER CLINIC PA
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City | PENSACOLA
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State | FL
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Zip | 32514
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Country | US
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Telephone | 850-474-8220
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Fax | 850-969-2187
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Provider Business Mailing Address
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Address Line | 3088 PALM TREE CT
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City | GULF BREEZE
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State | FL
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Zip | 32563-5667
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Country | US
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Telephone | 215-370-9577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001680
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4401
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPT13803TPL
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License Number State | CA
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