MEDICARE: NIKKOLE L MEYER APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN.CNP.0034892	OH

General Provider Information

NPI Number	:	1124806799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKOLE L MEYER APRN

Provider Business Mailing Address
First Line	:	3805 EDWARDS RD STE 450
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1948
Country	:	US
Telephone Number	:	513-924-5546
Fax Number	:

Provider Business Practice Location Address
First Line	:	3805 EDWARDS RD STE 450
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1948
Country	:	US
Telephone Number	:	513-924-5546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/15/2023

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