Provider Demographics
NPI:1982637138
Name:SVASTA, NICOLE ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:ELIZABETH
Last Name:SVASTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1331
Mailing Address - Country:US
Mailing Address - Phone:330-533-9488
Mailing Address - Fax:
Practice Address - Street 1:7750 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8419
Practice Address - Country:US
Practice Address - Phone:330-533-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide