Individual
JODI MICSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
715 E WESTERN RESERVE RD, POLAND, OH 44514-3358
(330) 726-3204
(330) 729-9316
Mailing address
PO BOX 636988, CINCINNATI, OH 45263-6988
(888) 940-2722
(513) 632-8898
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
APRN.CNP.16119
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.16119
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110786
—
OH
Enumeration date
08/10/2014
Last updated
10/11/2024
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