Provider Demographics
NPI:1285878744
Name:CHIKWA, NANCY IRENE (ACNP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:IRENE
Last Name:CHIKWA
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:IRENE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-245-3104
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:7675 WELLNESS WAY
Practice Address - Street 2:STE 202
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2509
Practice Address - Country:US
Practice Address - Phone:513-475-8523
Practice Address - Fax:513-475-7327
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN3013812364SA2100X
OHCOA.10626363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2983777Medicaid
OHNP31231Medicare PIN
OHH033550Medicare PIN