Provider Demographics
NPI:1740022201
Name:SHEARER, VIRGINIA (LICENCED OPTICIAN)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:SHEARER
Suffix:
Gender:F
Credentials:LICENCED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 BROOKVIEW ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4186
Mailing Address - Country:US
Mailing Address - Phone:760-224-5926
Mailing Address - Fax:
Practice Address - Street 1:3041 BROOKVIEW ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4186
Practice Address - Country:US
Practice Address - Phone:760-224-5926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK147118156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician