Healthcare Provider Details

I. General information

NPI: 1386936821
Provider Name (Legal Business Name): NANCI JO BILLOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 12/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6903 BURLINGTON PIKE SUITE A
FLORENCE KY
41042-1618
US

IV. Provider business mailing address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

V. Phone/Fax

Practice location:
  • Phone: 859-282-6700
  • Fax: 859-282-6760
Mailing address:
  • Phone: 513-862-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number44095
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.096684
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44095
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: