Provider Demographics
NPI:1790814416
Name:MCBRIER, NICOLE M (PA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:MCBRIER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:M
Other - Last Name:LIVECCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2121 HUGHES DR STE 710
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-5128
Mailing Address - Country:US
Mailing Address - Phone:419-291-2671
Mailing Address - Fax:419-291-2680
Practice Address - Street 1:2121 HUGHES DR STE 710
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5128
Practice Address - Country:US
Practice Address - Phone:419-291-2671
Practice Address - Fax:419-291-2680
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363AS0400X, 363AS0400X
OHAT0020482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer