| NPI | 1609082486 |
|---|---|
| Former Name | NICOLE DENISE NICKENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.020745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN346914) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH CNP020745) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-06-23 |