Individual
NICOLE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5660 OVERBROOKE RD, KETTERING, OH 45440-2317
(937) 231-3323
Mailing address
5660 OVERBROOKE RD, KETTERING, OH 45440-2317
(937) 231-3323
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5716461
—
OH
Enumeration date
09/25/2020
Last updated
11/23/2020
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