Individual
DR. NICOLE YODER ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1729 DAVIE AVE, STATESVILLE, NC 28677-3521
(704) 873-0524
(704) 873-0549
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2505
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
07/10/2017
Last updated
03/10/2022
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