Provider Demographics
NPI:1295861177
Name:MURPHY, JENNIFER L H (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L H
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-8782
Mailing Address - Country:US
Mailing Address - Phone:919-789-8253
Mailing Address - Fax:919-788-0228
Practice Address - Street 1:3150 ROGERS RD STE 110
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4196
Practice Address - Country:US
Practice Address - Phone:919-263-9163
Practice Address - Fax:919-263-9408
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1916152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC911087OtherEYEMED PROVIDER NUMBER
NC911087OtherEYEMED PROVIDER NUMBER
NC2473699BMedicare PIN