Healthcare Provider Details

I. General information

NPI: 1396175261
Provider Name (Legal Business Name): NAKKIYA GROOMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 ACADEMY AVE
CINCINNATI OH
45205-1623
US

IV. Provider business mailing address

846 ACADEMY AVE
CINCINNATI OH
45205-1623
US

V. Phone/Fax

Practice location:
  • Phone: 513-485-5361
  • Fax:
Mailing address:
  • Phone: 513-485-5361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: