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Individual

EDNA MAE NICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
537 E COLUMBIA ST, ALLIANCE, OH 44601-2550
(330) 823-0465
Mailing address
537 E COLUMBIA ST, ALLIANCE, OH 44601-2550
(330) 823-0465

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2829505
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2829505
OH
Enumeration date
07/27/2014
Last updated
07/27/2014
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