Healthcare Provider Details

I. General information

NPI: 1699605972
Provider Name (Legal Business Name): NICHOLAS RICO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

17349 SUGAR HILL TRL
CHAGRIN FALLS OH
44023-5629
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number158753
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: