TARA NICKUM

BATAVIA, OH
NPI1659808558
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: OH  APRNCNP020769)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: KY  3011176)
Enumeration Date2017-05-23
Last Update Date2017-05-23
Business Address
TARA NICKUM CNP
2080 ERION RD
BATAVIA, OH 45103-8928
Phone number: 513-403-4497
Mailing Address
TARA NICKUM CNP
2080 ERION RD
BATAVIA, OH 45103-8928
Phone number: 513-403-4497