Provider Demographics
NPI:1124413133
Name:BAQUERIZO NOLE, KATHERINE LESLIE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LESLIE
Last Name:BAQUERIZO NOLE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3130 HIGHLAND AVE
Mailing Address - Street 2:U CINCINNATI MEDICAL CENTER. DEPARTMENT OF DERMATOLOGY
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2399
Mailing Address - Country:US
Mailing Address - Phone:513-584-4644
Mailing Address - Fax:513-584-1559
Practice Address - Street 1:3130 HIGHLAND AVE
Practice Address - Street 2:U CINCINNATI MEDICAL CENTER. DEPARTMENT OF DERMATOLOGY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2399
Practice Address - Country:US
Practice Address - Phone:513-584-4644
Practice Address - Fax:513-584-1559
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2019-07-30
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Provider Licenses
StateLicense IDTaxonomies
OH35136377207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology