Individual
NICHOLE RAE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
2347 VINE ST, CINCINNATI, OH 45219-1745
(513) 621-1117
Mailing address
2347 VINE ST, CINCINNATI, OH 45219-1745
(513) 621-1117
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PRS.007526
OH
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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