Provider Demographics
NPI:1881875185
Name:ATHERTON, NICHOLE SUZANNE (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:SUZANNE
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:SUZANNE
Other - Last Name:MEISSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:202 W WILLOW AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6238
Mailing Address - Country:US
Mailing Address - Phone:559-302-5600
Mailing Address - Fax:559-302-5940
Practice Address - Street 1:202 W WILLOW AVE STE 402
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291
Practice Address - Country:US
Practice Address - Phone:559-302-5600
Practice Address - Fax:559-302-5940
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA907182086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery