Provider Demographics
NPI:1275114365
Name:AUBLE, NICOLE KRISTEN (OD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:KRISTEN
Last Name:AUBLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 WOODWINDS DR STE 230
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2539
Mailing Address - Country:US
Mailing Address - Phone:651-738-6500
Mailing Address - Fax:
Practice Address - Street 1:2080 WOODWINDS DR STE 230
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2539
Practice Address - Country:US
Practice Address - Phone:651-738-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3109152W00000X
390200000X
MN3946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program