Provider Demographics
NPI:1790093482
Name:BOMAR, NAKIA JAWELL (RN)
Entity type:Individual
Prefix:
First Name:NAKIA
Middle Name:JAWELL
Last Name:BOMAR
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 ENCLAVE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2981
Mailing Address - Country:US
Mailing Address - Phone:513-305-7590
Mailing Address - Fax:513-305-7590
Practice Address - Street 1:3812 ENCLAVE AVE APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2981
Practice Address - Country:US
Practice Address - Phone:513-305-7590
Practice Address - Fax:513-305-7590
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.521166163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse