Nickens, Nicole Denise

Nickens, Nicole Denise is an individual health care provider with primary practice located at 30841 Euclid Ave Ste 103 , Willoughby OH 44094-3100. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Nickens, Nicole Denise can be contacted via phone (216) 441-2496.

Contact Information

Primary practice address
30841 Euclid Ave Ste 103 Willoughby OH 44094-3100
Phone: (216) 441-2496
Fax: (216) 453-5966
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X CNP020745 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN.CNP.020745 Ohio
Nursing Service Providers / Registered Nurse 163W00000X RN346914 Ohio

Profile Details

NPI number 1609082486
LBN Legal business name Nickens, Nicole Denise
Credentials MSN, A-GPNP-BC,
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2007
Last updated Feb 13th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609082486 NPPES
Ohio MEDICAID 0223866
Ohio MEDICAID 2462777
Ohio MEDICAID 1609082486

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