Provider Demographics
NPI:1356789804
Name:VERNILLO, LINDSEY MICHELLE (OD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:VERNILLO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4152
Mailing Address - Country:US
Mailing Address - Phone:757-482-4022
Mailing Address - Fax:757-482-9065
Practice Address - Street 1:160 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4152
Practice Address - Country:US
Practice Address - Phone:757-482-4022
Practice Address - Fax:757-482-9065
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002242152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist