MEDICARE: MISS NINA M NEMETZ OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OD856	HI

General Provider Information

NPI Number	:	1003080516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NINA M NEMETZ OD

Provider Business Mailing Address
First Line	:	68-1820 WAIKOLOA RD STE 305
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5597
Country	:	US
Telephone Number	:	808-909-2048
Fax Number	:

Provider Business Practice Location Address
First Line	:	68-1820 WAIKOLOA RD STE 305
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5597
Country	:	US
Telephone Number	:	808-909-2048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	10/16/2023

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