Provider Demographics
NPI:1982734844
Name:KENT-STROLLO, NICOLE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:KENT-STROLLO
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:KENT-STROLLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:22 MCCLURG RD
Mailing Address - Street 2:BOARDMAN
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6736
Mailing Address - Country:US
Mailing Address - Phone:330-965-9400
Mailing Address - Fax:330-953-3330
Practice Address - Street 1:22 MCCLURG RD
Practice Address - Street 2:BOARDMAN
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6736
Practice Address - Country:US
Practice Address - Phone:330-965-9400
Practice Address - Fax:330-953-3330
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-07081363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3016391Medicaid
OHNP33271Medicare UPIN