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General NPI Number Information
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NPI Number | 1073609715
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Entity Type | Individual
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Provider Name | JEANNY M LIU-WU OD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | PEARLE VISION 3001 WHITE BEAR AVE. NO., SUITE 1050
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City | ST. PAUL
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State | MN
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Zip | 55109
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Country | US
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Telephone | 651-770-3923
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Fax | 651-770-5316
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Provider Business Mailing Address
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Address Line | 3781 FAIRWAY DRIVE
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-735-3477
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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 | 2339
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License Number State | MN
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