Individual
NICOLE G. TESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
21475 RIDGETOP CIRCLE SUITE 300, STERLING, VA 20166-8580
(703) 430-4400
(703) 430-4130
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001386
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010118654
—
VA
05
—
010118727
—
VA
05
—
010118760
—
VA
05
—
010118794
—
VA
05
—
1316029739
—
VA
01
—
175682
ANTHEM BCBS/HEALTHKEEPERS
VA
01
—
175687
ANTHEM BCBS/HEALTHKEEPERS
VA
01
—
175689
ANTHEM BCBS/HEALTHKEEPERS
VA
01
—
175691
ANTHEM BCBS/HEALTHKEEPERS
VA
Enumeration date
10/19/2006
Last updated
11/29/2022
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