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General NPI Number Information
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NPI Number | 1902368939
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Entity Type | Individual
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Provider Name | NICOLE DAWN CHANEY O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2019
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1124 KEMPER MEADOW DR
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City | CINCINNATI
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State | OH
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Zip | 45240-4117
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Country | US
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Telephone | 513-851-2414
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Fax |
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Provider Business Mailing Address
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Address Line | 18 HOLLEY CT
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City | SPRINGBORO
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State | OH
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Zip | 45066-8578
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Country | US
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Telephone | 405-420-4336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2968
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.006810
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License Number State | OH
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