Healthcare Provider Details

I. General information

NPI: 1821933151
Provider Name (Legal Business Name): NICOLE GLATZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3188 BELLEVUE AVE
CINCINNATI OH
45219-2369
US

IV. Provider business mailing address

3188 BELLEVUE AVE
CINCINNATI OH
45219-2369
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-6127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835S0206X
TaxonomySolid Organ Transplant Pharmacist
License Number03445663
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: