Provider Demographics
NPI:1205029147
Name:HERMAN, JOCELYN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:MARIE
Last Name:HERMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOCELYN
Other - Middle Name:MARIE
Other - Last Name:MOGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2005 KNIGHT LANE BLDG. H ATTN: MEDICAL STAFF SERVICES
Mailing Address - Street 2:NAVY MEDICINE SUPPORT COMMAND
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32212-0140
Mailing Address - Country:US
Mailing Address - Phone:904-542-7200
Mailing Address - Fax:
Practice Address - Street 1:BHC, M BLDG. 669
Practice Address - Street 2:
Practice Address - City:PARRIS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29905
Practice Address - Country:US
Practice Address - Phone:843-228-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7071T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist