Healthcare Provider Details

I. General information

NPI: 1235926023
Provider Name (Legal Business Name): NICHOLAS LUKENS RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MONROE ST
MIDDLETOWN OH
45042-3214
US

IV. Provider business mailing address

201 MONROE ST
MIDDLETOWN OH
45042-3214
US

V. Phone/Fax

Practice location:
  • Phone: 513-213-1641
  • Fax:
Mailing address:
  • Phone: 513-213-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN.369818
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: