Nicole Clark, LDO
Technician/Technologist, Optician in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1902699499
StatusActive
Last updated in NPPESMay 27, 2025
Details
- NPI
- 1902699499
- Entity type
- Individual (NPI-1)
- Name
- Nicole Clark
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 27, 2025
- Certification date
- May 27, 2025
- Last updated
- May 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 527 | NV | Yes |
Practice location
3950 W Lake Mead BlvdNorth Las Vegas, NV 89032-4895
Phone 702-631-8472 · Fax 702-631-9417
Mailing address
8137 Redbud Vine StNorth Las Vegas, NV 89085-4456
Phone 707-758-3386
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