Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 1101003141 | VA |
N | 156FC0801X | Contact Lens Fitter | 1101003141 | VA |
N | 156FX1100X | Ophthalmic | 1101003141 | VA |
Y | 156FX1800X | Optician | 1101003141 | VA |
NPI | 1457701351 |
---|---|
Provider Name | Ms. Nada Chedid |
First Address | Stafford, VA 22554-8513 |
Second Address | Stafford, VA 22554-8513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 21/06/2016 |