Provider Demographics
NPI:1578788154
Name:MERRYMAN, AUDREY KAREN
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:KAREN
Last Name:MERRYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:AUDREY
Other - Middle Name:KAREN
Other - Last Name:SVARVARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4280 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6656
Mailing Address - Country:US
Mailing Address - Phone:719-520-3333
Mailing Address - Fax:
Practice Address - Street 1:4280 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6656
Practice Address - Country:US
Practice Address - Phone:719-520-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2432152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist