Provider Demographics
NPI:1730919200
Name:CASKEY, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:CASKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:PIERPONT
Mailing Address - State:OH
Mailing Address - Zip Code:44082-0033
Mailing Address - Country:US
Mailing Address - Phone:440-812-4014
Mailing Address - Fax:
Practice Address - Street 1:612 PENN LINE RD
Practice Address - Street 2:
Practice Address - City:PIERPONT
Practice Address - State:OH
Practice Address - Zip Code:44082-9730
Practice Address - Country:US
Practice Address - Phone:440-812-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide