Provider Demographics
NPI:1033375183
Name:MORRISSEY, NICOLE ANN (OD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANN
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-3353
Mailing Address - Country:US
Mailing Address - Phone:402-420-2020
Mailing Address - Fax:402-223-5286
Practice Address - Street 1:7930 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2500
Practice Address - Country:US
Practice Address - Phone:402-420-2020
Practice Address - Fax:402-323-2002
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE1307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist