Provider Demographics
NPI:1518484617
Name:RONEY, JENNA LYNN (OD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:RONEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNA
Other - Middle Name:L
Other - Last Name:RONEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2603 HOLLY HILL ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5156
Mailing Address - Country:US
Mailing Address - Phone:336-228-1766
Mailing Address - Fax:336-228-6432
Practice Address - Street 1:2603 HOLLY HILL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5156
Practice Address - Country:US
Practice Address - Phone:336-228-1766
Practice Address - Fax:336-228-6432
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2497152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist