Healthcare Provider Details

I. General information

NPI: 1629998679
Provider Name (Legal Business Name): JOELLE NICOLE WASIKOWSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3188 BELLEVUE AVE
CINCINNATI OH
45219-2369
US

IV. Provider business mailing address

3130 HIGHLAND AVE
CINCINNATI OH
45219-2399
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1000
  • Fax:
Mailing address:
  • Phone: 513-584-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446935
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: