Healthcare Provider Details

I. General information

NPI: 1174437701
Provider Name (Legal Business Name): NICOLE OFFNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LEA AVE STE 760
NASHVILLE TN
37210-3541
US

IV. Provider business mailing address

209 MAXWELL ST
PITTSBURGH PA
15205-2030
US

V. Phone/Fax

Practice location:
  • Phone: 201-526-8484
  • Fax: 615-610-0749
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN687100
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: