Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 7484 | NC |
NPI | 1043370521 |
---|---|
Provider Name | Dr. Nicole Marie Scheffler |
First Address | Boone, NC 28607 |
Second Address | Boone, NC 28607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0148020055 | ADA (01) | |
BS7922619 | DEA (01) |