Individual
NICHOLE LAUREN BANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4101 N 56TH ST, MILWAUKEE, WI 53216-1267
(414) 447-9403
Mailing address
2008 N 50TH DR, PHOENIX, AZ 85035-3925
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002730
AZ
Other
Enumeration date
06/05/2023
Last updated
06/07/2024
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