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General NPI Number Information
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NPI Number | 1497241665
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Entity Type | Individual
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Provider Name | MICHELE L NICHOLAS FNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 19327 WESTWOOD DR
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City | STRONGSVILLE
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State | OH
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Zip | 44149-4132
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Country | US
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Telephone | 216-456-1998
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Fax |
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Provider Business Mailing Address
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Address Line | 19327 WESTWOOD DR
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City | STRONGSVILLE
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State | OH
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Zip | 44149-4132
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Country | US
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Telephone | 216-456-1998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 002975
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License Number State | OH
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