Provider Demographics
NPI:1790271971
Name:MEADE, NICOLE LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:MEADE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:LYNN
Other - Last Name:MEADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 21351
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-0351
Mailing Address - Country:US
Mailing Address - Phone:614-776-4379
Mailing Address - Fax:
Practice Address - Street 1:3924 MOUNTVIEW RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-4806
Practice Address - Country:US
Practice Address - Phone:614-776-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily