Healthcare Provider Details

I. General information

NPI: 1801786900
Provider Name (Legal Business Name): NICHOLE MICHELLE NATION RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICHOLE MICHELLE GALL RN

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 ROCKY LN
ASHLAND OH
44805-4701
US

IV. Provider business mailing address

2233 ROCKY LN
ASHLAND OH
44805-4701
US

V. Phone/Fax

Practice location:
  • Phone: 419-281-3716
  • Fax: 419-281-4605
Mailing address:
  • Phone: 419-281-3716
  • Fax: 419-281-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.362238
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: