Healthcare Provider Details

I. General information

NPI: 1417606765
Provider Name (Legal Business Name): NICOLE MARIE SZUMINSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4389 WETMORE RD E
COLUMBUS OH
43224-5125
US

IV. Provider business mailing address

4389 WETMORE RD E
COLUMBUS OH
43224-5125
US

V. Phone/Fax

Practice location:
  • Phone: 781-307-1148
  • Fax:
Mailing address:
  • Phone: 781-307-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number389515
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: