Provider Demographics
NPI:1235740556
Name:NATHWANI, LUCILLE ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:LUCILLE
Middle Name:ELIZABETH
Last Name:NATHWANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LUCILLE
Other - Middle Name:ELIZABETH
Other - Last Name:RORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-6200
Mailing Address - Fax:513-245-3672
Practice Address - Street 1:3188 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2369
Practice Address - Country:US
Practice Address - Phone:513-558-5661
Practice Address - Fax:513-475-7348
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9699-33363L00000X
OHAPRN.CNP.0032280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner