Provider Demographics
NPI:1780223651
Name:MCINTYRE, NORA ROSE (RN)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:ROSE
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2328
Mailing Address - Country:US
Mailing Address - Phone:614-738-5515
Mailing Address - Fax:
Practice Address - Street 1:785 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2328
Practice Address - Country:US
Practice Address - Phone:614-738-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH402431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse