Healthcare Provider Details

I. General information

NPI: 1235055112
Provider Name (Legal Business Name): MRS. MICHELLE LEE NAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6458 TAYLOR TRACE LN
FAIRFIELD TOWNSHIP OH
45011-7171
US

IV. Provider business mailing address

6458 TAYLOR TRACE LN
FAIRFIELD TOWNSHIP OH
45011-7171
US

V. Phone/Fax

Practice location:
  • Phone: 513-939-5570
  • Fax:
Mailing address:
  • Phone: 513-939-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: