Diane Nicholson
Individual provider Active NPI Licensed Practical Nurse · Holgate, OH
NPI 1376903773 · NPPES record last updated Feb 26, 2016
Key facts
- NPI
- 1376903773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN057904 (OH)
- Practice address
- 801 Joe E Brown Ave
Holgate, OH 43527-9802 - Phone
- (419) 264-5231
- NPI assigned
- Feb 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN057904 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN057904 | OH | Yes |
Addresses
Primary practice location
801 Joe E Brown Ave
Holgate, OH 43527-9802
Mailing address
801 Joe E Brown Ave
Holgate, OH 43527-9802
Other providers in Holgate, OH
- Geraldine A Hernandez
- Holgate Care Center, LLC
- Holgate Care Center, LLC
- Holgate Local School District
- Katelyn Moreno
- Myriah Leigh Rode
- Theresa Rodriguez
- Rachel Wells
All providers in Holgate, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.