Provider Demographics
NPI:1407290190
Name:QUARLES, NICOLE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:QUARLES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6474 JAMISON WAY APT 2
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9504
Mailing Address - Country:US
Mailing Address - Phone:513-849-7445
Mailing Address - Fax:
Practice Address - Street 1:6474 JAMISON WAY
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9504
Practice Address - Country:US
Practice Address - Phone:513-849-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN528517163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty