Individual
EVE LAZELL NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN.
Contact information
Practice address
12625 BRITTON DR, CLEVELAND, OH 44120-1010
(623) 313-6315
Mailing address
12625 BRITTON DR, CLEVELAND, OH 44120-1010
(623) 313-6315
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN121571
OH
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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