Provider Demographics
NPI:1619365582
Name:NIKKI'S COMPASSIONATE CARE
Entity Type:Organization
Organization Name:NIKKI'S COMPASSIONATE CARE
Other - Org Name:NIKKI'S COMPASSIONATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STNA
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-319-0198
Mailing Address - Street 1:30 E MITCHELL AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1553
Mailing Address - Country:US
Mailing Address - Phone:513-319-0198
Mailing Address - Fax:
Practice Address - Street 1:30 E MITCHELL AVE APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1553
Practice Address - Country:US
Practice Address - Phone:513-319-0198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401112700710251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care