Individual
MS. NICOLE DENISE NICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, A-GPNP-BC,
Contact information
Practice address
12395 MCCRACKEN RD, GARFIELD HTS, OH 44125-2967
(216) 587-6727
Mailing address
12395 MCCRACKEN RD, GARFIELD HTS, OH 44125-2967
(216) 587-6727
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN346914
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
CNP020745
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.020745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0223866
—
OH
05
—
0323866
—
OH
05
—
1609082486
—
OH
05
—
2462777
—
OH
Enumeration date
05/16/2007
Last updated
03/11/2026
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