Healthcare Provider Details

I. General information

NPI: 1306502430
Provider Name (Legal Business Name): NICHOL LEE MCGUIRE-HART CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICHOL LEE MCGUIRE CDCA

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2895 HARDING HWY
LIMA OH
45804-3408
US

IV. Provider business mailing address

2895 HARDING HWY
LIMA OH
45804-3408
US

V. Phone/Fax

Practice location:
  • Phone: 419-221-2821
  • Fax:
Mailing address:
  • Phone: 419-221-2821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: