Individual
DR. NICOLE HANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1537 S SCATTERFIELD RD STE B, ANDERSON, IN 46016-5783
(765) 649-1200
(765) 649-4040
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 993-0031
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011370
IL
152W00000X
Optometrist
18004133A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046011370
—
IL
Enumeration date
10/08/2018
Last updated
04/21/2026
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