Individual
NICOLE CARROLL JANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2139 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 585-4157
(513) 585-4244
Mailing address
3142 COURT VIEW DR APT 2, BEAVERCREEK, OH 45431-8841
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0413894
—
OH
Enumeration date
01/31/2020
Last updated
10/24/2023
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