Healthcare Provider Details

I. General information

NPI: 1801757224
Provider Name (Legal Business Name): NICOLE RENEE BECK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6941 KENWOOD RD
CINCINNATI OH
45243-2327
US

IV. Provider business mailing address

11104 KEMPER AVE
BLUE ASH OH
45242-1974
US

V. Phone/Fax

Practice location:
  • Phone: 513-538-4327
  • Fax: 513-271-8033
Mailing address:
  • Phone: 859-750-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0040761
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0040761
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: