Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1855 | CT |
NPI | 1184387466 |
---|---|
Provider Name | Ms. Nicole Lynne Heslin |
First Address | Plainville, CT 06062-2817 |
Second Address | Avon, CT 06001-3684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2021 |
Last Update Date | 14/10/2021 |