Healthcare Provider Details

I. General information

NPI: 1326950106
Provider Name (Legal Business Name): CAROL SUE GULICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 LOVELAND MIAMIVILLE RD
LOVELAND OH
45140-6939
US

IV. Provider business mailing address

536 COMMON WEALTH DR
CINCINNATI OH
45244-1031
US

V. Phone/Fax

Practice location:
  • Phone: 513-904-5143
  • Fax:
Mailing address:
  • Phone: 513-904-5143
  • Fax: 513-575-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number190134
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: