Forney, Nicole M

Forney, Nicole M is an individual health care provider with primary practice located at 2630 Westview Dr , Wyomissing PA 19610-1130. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Forney, Nicole M can be contacted via phone (610) 376-1981.

Contact Information

Primary practice address
2630 Westview Dr Wyomissing PA 19610-1130
Fax: (610) 376-3153
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OEG001274 Pennsylvania

Profile Details

NPI number 1053316687
LBN Legal business name Forney, Nicole M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Mar 22nd, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053316687 NPPES
Pennsylvania MEDICAID 1018674770001

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