Provider Demographics
NPI:1508452905
Name:NATION, ALICIA KAYE (CNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:KAYE
Last Name:NATION
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:KAYE
Other - Last Name:GLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6847 N CHESTNUT ST STE 325
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-297-2401
Mailing Address - Fax:330-297-4485
Practice Address - Street 1:6847 N CHESTNUT ST STE 325
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-297-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0496866Medicaid