Provider Demographics
NPI:1366000879
Name:SHEFFER, NICOLE N (OD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:N
Last Name:SHEFFER
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8401 GOLDEN VALLEY RD STE 330
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4488
Mailing Address - Country:US
Mailing Address - Phone:763-416-7629
Mailing Address - Fax:763-383-4147
Practice Address - Street 1:12000 ELM CREEK BLVD N STE 100
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7074
Practice Address - Country:US
Practice Address - Phone:763-416-7600
Practice Address - Fax:763-416-7634
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2020-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN3634152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics