Nicole Lynn Colvin
Individual provider Active NPI Optician · Sandersville, GA
NPI 1235975277 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1235975277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- LDO002294 (GA)
- Practice address
- 1308 S Harris St
Sandersville, GA 31082-6913 - Phone
- (478) 553-9099
- Fax
- (478) 553-9518
- NPI assigned
- Jul 8, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDO002294 | GA | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO002294 | GA | Yes |
Addresses
Primary practice location
1308 S Harris St
Sandersville, GA 31082-6913
Mailing address
1308 S Harris St
Sandersville, GA 31082-6913
Phone (478) 553-9099
Other providers in Sandersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.