Healthcare Provider Details

I. General information

NPI: 1598127094
Provider Name (Legal Business Name): NICOLE C STARR MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE C CRAKER MD, MPH

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 230
CINCINNATI OH
45236-2921
US

IV. Provider business mailing address

8044 MONTGOMERY RD STE 230
CINCINNATI OH
45236-2921
US

V. Phone/Fax

Practice location:
  • Phone: 832-353-2880
  • Fax:
Mailing address:
  • Phone: 513-984-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number56959
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number35.144378
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number56959
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number35.144378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: