Provider Demographics
NPI:1598796302
Name:FIOR NOSSEK, FELICIA M (NP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:M
Last Name:FIOR NOSSEK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:112 INDEPENDENCE WAY STE 160
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-9813
Practice Address - Country:US
Practice Address - Phone:419-502-3534
Practice Address - Fax:567-855-5231
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN197847163WP0808X
OHNS08589363LP0808X
OHAPRN.CNS.08589364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2943917Medicaid
OH9375981Medicare PIN
OHNP20383Medicare PIN
OHFINP20682Medicare PIN