Provider Demographics
NPI:1003080516
Name:NEMETZ, NINA M (OD)
Entity Type:Individual
Prefix:MISS
First Name:NINA
Middle Name:M
Last Name:NEMETZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:NINA
Other - Middle Name:M
Other - Last Name:NEMETZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:68-1820 WAIKOLOA RD STE 305
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5597
Mailing Address - Country:US
Mailing Address - Phone:808-909-2048
Mailing Address - Fax:
Practice Address - Street 1:68-1820 WAIKOLOA RD STE 305
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5597
Practice Address - Country:US
Practice Address - Phone:808-909-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD856152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHI09817Medicare PIN