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General NPI Number Information
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NPI Number | 1336336015
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Entity Type | Organization
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Legal Business Name | STEVEN B. NICHOLSON,O.D., PC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 2727 W 2ND ST SUITE 318
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City | HASTINGS
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State | NE
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Zip | 68901-4684
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Country | US
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Telephone | 402-463-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 W 2ND ST SUITE 318
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City | HASTINGS
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State | NE
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Zip | 68901-4684
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN B. NICHOLSON
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Credential |
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Telephone | 402-463-1327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 830
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License Number State | NE
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