Willard, Jenna Michelle
Willard, Jenna Michelle is an individual health care provider with primary practice located at 19 Village Sq , Chelmsford MA 01824-2712. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Willard, Jenna Michelle can be contacted via phone (978) 256-5600.Contact Information
Primary practice address
19 Village Sq
Chelmsford MA 01824-2712
Phone: (978) 256-5600
Fax: (978) 703-0250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5166 | Massachusetts |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG003049 | Pennsylvania |
Profile Details
| NPI number | 1558744409 |
|---|---|
| LBN Legal business name | Willard, Jenna Michelle |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2015 |
| Last updated | Dec 15th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558744409 | NPPES |
| Massachusetts | MEDICAID | 110116574A |
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