Provider Demographics
NPI:1659941912
Name:TAFURI, NICOLE LAUREN (APRN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LAUREN
Last Name:TAFURI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2753 ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2204
Mailing Address - Country:US
Mailing Address - Phone:513-246-8000
Mailing Address - Fax:513-871-2824
Practice Address - Street 1:2753 ERIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2204
Practice Address - Country:US
Practice Address - Phone:513-246-8000
Practice Address - Fax:513-871-2824
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029116363L00000X
OHCNP.0029116363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid