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General NPI Number Information
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NPI Number | 1528143781
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Entity Type | Individual
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Provider Name | JENNIFER LYNN BORGES O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 7070 TAMARACK RD
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City | WOODBURY
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State | MN
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Zip | 55125-1205
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Country | US
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Telephone | 612-540-5473
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Fax | 612-540-5474
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Provider Business Mailing Address
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Address Line | 3570 SPRINGWOOD PATH
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City | EAGAN
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State | MN
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Zip | 55123-1353
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Country | US
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Telephone | 612-540-5473
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Fax | 612-540-5474
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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 | 3001
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License Number State | FL
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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 | 2467
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License Number State | MN
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