Provider Demographics
NPI:1538403308
Name:KEHRES, NICOLE ALANA (MS)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ALANA
Last Name:KEHRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:ALANA
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:33790 BAINBRIDGE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2982
Mailing Address - Country:US
Mailing Address - Phone:440-287-7463
Mailing Address - Fax:
Practice Address - Street 1:33790 BAINBRIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2982
Practice Address - Country:US
Practice Address - Phone:440-600-7151
Practice Address - Fax:419-524-4617
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03067231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA01301OtherAUDIOLOGIST