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NPI Code Detail

MEDICARE: NICOLE CONIGLIO ACNP

MEDICARE: NICOLE CONIGLIO ACNP
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
1363LA2100XAcute Care Nurse Practitioner13892OH
2364SA2100XAcute Care Clinical Nurse SpecialistCOA.13892-NPOH

General Provider Information

NPI Number : 1457794166
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CONIGLIO ACNP
Provider Business Mailing Address
First Line : 3593 MEDINA RD # 181
Second Line :
City : MEDINA
State : OH
Zip : 44256-8182
Country : US
Telephone Number : 330-416-2787
Fax Number : 866-519-5293
Provider Business Practice Location Address
First Line : 3593 MEDINA RD # 181
Second Line :
City : MEDINA
State : OH
Zip : 44256-8182
Country : US
Telephone Number : 330-416-2787
Fax Number : 866-519-5293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2013
Last Update Date : 06/05/2015

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