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NPI Code Detail

MEDICARE: NICOLE RESETAR

MEDICARE: NICOLE RESETAR
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
12255A2300XAthletic TrainerOH
2390200000XStudent in an Organized Health Care Education/Training ProgramOH
32255A2300XAthletic TrainerAT006606OH

General Provider Information

NPI Number : 1164002325
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE RESETAR
Provider Business Mailing Address
First Line : 375 DIXMYTH AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2489
Country : US
Telephone Number : 513-862-1400
Fax Number :
Provider Business Practice Location Address
First Line : 375 DIXMYTH AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2489
Country : US
Telephone Number : 513-862-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2021
Last Update Date : 11/20/2024

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1093387805 — MRS. STACY ALLISON MARSHALL CRNA, DNP
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Directions to “ NICOLE RESETAR ” Practice Location

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