Jennifer Marie Brusven, LDO
Technician/Technologist, Optician in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1144097601
StatusActive
Last updated in NPPESDec 5, 2023
Details
- NPI
- 1144097601
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Marie Brusven
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 5, 2023
- Certification date
- Dec 5, 2023
- Last updated
- Dec 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 689 | NV | Yes |
| 156FC0801X | Technician/Technologist, Contact Lens Fitter | 689 | NV |
Practice location
2650 E Craig RdNorth Las Vegas, NV 89030-3399
Phone 702-399-3722 · Fax 702-399-3145
Mailing address
2650 E Craig RdNorth Las Vegas, NV 89030-3399
Phone 702-399-3722 · Fax 702-399-3145
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