Provider Demographics
NPI:1407735913
Name:MILLISER, NICOLE ANGELINA (RN)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANGELINA
Last Name:MILLISER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:ANGELINA
Other - Last Name:NICKOLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2400 DEEDS RD
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9698
Mailing Address - Country:US
Mailing Address - Phone:740-405-0958
Mailing Address - Fax:
Practice Address - Street 1:2658 N COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8744
Practice Address - Country:US
Practice Address - Phone:740-277-6269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH389356163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice