Healthcare Provider Details

I. General information

NPI: 1891522173
Provider Name (Legal Business Name): NICOLE SCHUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4345 GLEN ESTE WITHAMSVILLE RD APT 454
CINCINNATI OH
45245-1892
US

IV. Provider business mailing address

4345 GLEN ESTE WITHAMSVILLE RD APT 454
CINCINNATI OH
45245-1892
US

V. Phone/Fax

Practice location:
  • Phone: 513-703-9166
  • Fax:
Mailing address:
  • Phone: 513-703-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: