Provider Demographics
NPI:1346818804
Name:RAMIREZ, NIKOLE (LPN, MDS COORDINATOR)
Entity Type:Individual
Prefix:
First Name:NIKOLE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LPN, MDS COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7696 COUNTY ROAD 28
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:IN
Mailing Address - Zip Code:46721-9720
Mailing Address - Country:US
Mailing Address - Phone:419-212-2494
Mailing Address - Fax:
Practice Address - Street 1:702 N SAWYER RD
Practice Address - Street 2:
Practice Address - City:KENDALLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46755-2532
Practice Address - Country:US
Practice Address - Phone:260-347-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27074685A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse