Amidon, Nicole L
Amidon, Nicole L is an individual health care provider with primary practice located at 459 W Johnson St , Fond Du Lac WI 54935-3170. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Amidon, Nicole L can be contacted via phone (920) 922-5990.Contact Information
Primary practice address
459 W Johnson St
Fond Du Lac WI 54935-3170
Phone: (920) 922-5990
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2758-.035 | Wisconsin |
Profile Details
| NPI number | 1992762835 |
|---|---|
| LBN Legal business name | Amidon, Nicole L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Dec 21st, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992762835 | NPPES |
| Other | WI2758 | EYEMED VISION NO. | |
| MEDICAID | 38611200 | EYEMED VISION NO. |
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