Provider Demographics
NPI:1013170380
Name:CLINE, AME NICOLE (OD)
Entity Type:Individual
Prefix:MRS
First Name:AME
Middle Name:NICOLE
Last Name:CLINE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:AME
Other - Middle Name:NICOLE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3769 COLUMBUS PIKE STE 115
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7213
Mailing Address - Country:US
Mailing Address - Phone:407-612-0200
Mailing Address - Fax:614-781-8895
Practice Address - Street 1:3769 COLUMBUS PIKE STE 115
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7213
Practice Address - Country:US
Practice Address - Phone:740-761-2020
Practice Address - Fax:614-781-8895
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5786152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCL4245271Medicare UPIN
9928931Medicare PIN