Provider Demographics
NPI:1235288218
Name:REE, JERILYN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:JERILYN
Middle Name:MARIE
Last Name:REE
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24076 757TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-6807
Mailing Address - Country:US
Mailing Address - Phone:928-853-6878
Mailing Address - Fax:507-373-7220
Practice Address - Street 1:1550 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-6304
Practice Address - Country:US
Practice Address - Phone:928-853-6878
Practice Address - Fax:507-373-7220
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ927152W00000X
MN2413152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist