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NPI Code Detail

MEDICARE: NANDRA NICKELL PHILLIPS

MEDICARE: NANDRA NICKELL PHILLIPS
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
1376K00000XNurse's Aide400084370202OH

General Provider Information

NPI Number : 1699596932
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANDRA NICKELL PHILLIPS
Provider Business Mailing Address
First Line : 2371 WILSON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45231-1328
Country : US
Telephone Number : 513-780-4200
Fax Number :
Provider Business Practice Location Address
First Line : 2371 WILSON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45231-1328
Country : US
Telephone Number : 513-780-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2024
Last Update Date : 10/19/2024

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Directions to “ NANDRA NICKELL PHILLIPS ” Practice Location

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