Jennifer Leigh Martin
Individual provider Active NPI Optician · Ft Wright, KY
NPI 1558095828 · NPPES record last updated Jul 13, 2022
Key facts
- NPI
- 1558095828
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 268337 (KY)
- Practice address
- 3450 Valley Plaza Pkwy
Ft Wright, KY 41017-8177 - Phone
- (859) 341-3767
- Fax
- (859) 341-3789
- NPI assigned
- Jul 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 268337 | KY | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 268337 | KY | Yes |
Addresses
Primary practice location
3450 Valley Plaza Pkwy
Ft Wright, KY 41017-8177
Mailing address
3450 Valley Plaza Pkwy
Ft Wright, KY 41017-8177
Phone (859) 341-3767
Other providers in Ft Wright, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.