Provider Demographics
NPI:1730215930
Name:BOWERS, JENNIFER BRAUN
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BRAUN
Last Name:BOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD,FAAO
Mailing Address - Street 1:792 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6050
Mailing Address - Country:US
Mailing Address - Phone:757-705-3082
Mailing Address - Fax:
Practice Address - Street 1:701 LYNNHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7299
Practice Address - Country:US
Practice Address - Phone:757-486-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001612152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management