Individual
DEBORAH NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IP
Contact information
Practice address
390 SHAWNEE RD, OTWAY, OH 45657-8886
(937) 544-4017
Mailing address
390 SHAWNEE RD, OTWAY, OH 45657-8886
(937) 544-4017
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2684528
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2684528
—
OH
Enumeration date
06/10/2008
Last updated
06/10/2008
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