Provider Demographics
NPI:1760506224
Name:PRICE, NICOLE JANET (STNA)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JANET
Last Name:PRICE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4639
Mailing Address - Country:US
Mailing Address - Phone:419-581-2401
Mailing Address - Fax:
Practice Address - Street 1:320 GEORGE ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4639
Practice Address - Country:US
Practice Address - Phone:419-581-2401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400533160906376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2270591Medicaid