Provider Demographics
NPI:1790976835
Name:TUCCI, NICOLE MARIE (RN)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:MARIE
Last Name:TUCCI
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 1:4814 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:LOWELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44436-9708
Mailing Address - Country:US
Mailing Address - Phone:330-261-3429
Mailing Address - Fax:
Practice Address - Street 1:4814 NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:LOWELLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44436-9708
Practice Address - Country:US
Practice Address - Phone:330-261-3429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.312234163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology