Provider Demographics
NPI:1265745558
Name:HELTON, NICOLE THERESE (OD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:THERESE
Last Name:HELTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:THERESE
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:17151 MERCANTILE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3942
Practice Address - Country:US
Practice Address - Phone:317-259-4234
Practice Address - Fax:317-259-1538
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003646B152W00000X
IN18003646A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist