Individual
AUTUMN NICOLE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
156 HENN HYDE RD NE, WARREN, OH 44484-1201
(234) 600-9683
Mailing address
156 HENN HYDE RD NE, WARREN, OH 44484-1201
(234) 600-9683
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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