=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053115410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE KASER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2025
-----------------------------------------------------
Last Update Date | 04/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 VALLEY ST APT B74
-----------------------------------------------------
City | MINERVA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44657-9798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-804-9618
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11500 LINCOLN ST SE
-----------------------------------------------------
City | ROBERTSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-205-8256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------