Individual
STEVEN BURDETTE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1414 W 12TH ST, HASTINGS, NE 68901-3742
(402) 462-9191
Mailing address
1414 W 12TH ST, HASTINGS, NE 68901-3742
(402) 462-9191
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
830
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249873-00
—
NE
Enumeration date
08/21/2006
Last updated
03/14/2014
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