MEDICARE: NICHOLAS STUDDARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		OH

General Provider Information

NPI Number	:	1225983406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS STUDDARD

Provider Business Mailing Address
First Line	:	4197 W 20TH ST APT 113
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-3461
Country	:	US
Telephone Number	:	216-358-7237
Fax Number	:

Provider Business Practice Location Address
First Line	:	4197 W 20TH ST APT 113
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-3461
Country	:	US
Telephone Number	:	216-358-7237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ NICHOLAS STUDDARD ” Practice Location

Language	Start Address	Practice Location

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