Provider Demographics
NPI:1679821235
Name:APPLE, NICOLE PIATT (OD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:PIATT
Last Name:APPLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:ALEXANDRIA
Other - Last Name:APPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2170 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2927
Mailing Address - Country:US
Mailing Address - Phone:910-295-2100
Mailing Address - Fax:910-295-3625
Practice Address - Street 1:2170 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2927
Practice Address - Country:US
Practice Address - Phone:910-295-2100
Practice Address - Fax:910-295-3625
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2300152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1679821235Medicaid
NCNC93480355Medicare PIN