Moffett, Nicole Renee
Moffett, Nicole Renee is an sole proprietor health care provider with primary practice located at 2365 Crain Hwy , Waldorf MD 20601-3167. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Moffett, Nicole Renee can be contacted via phone (301) 932-9408.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TA1223 | Maryland |
Profile Details
| NPI number | 1366574808 |
|---|---|
| LBN Legal business name | Moffett, Nicole Renee |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 11th, 2007 |
| Last updated | Sep 27th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366574808 | NPPES |
| Maryland | MEDICAID | 4463081 00 |
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