Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 5165 | NV |
NPI | 1023225703 |
---|---|
Provider Name | Dr. Nicole Michelle Stoker |
First Address | Cincinnati, OH 45208-1841 |
Second Address | Reno, NV 89509-5430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |