Provider Demographics
NPI:1528635257
Name:ORAVEC, NICHOLAS J (BC-HIS, MPO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ORAVEC
Suffix:
Gender:M
Credentials:BC-HIS, MPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 1/2 MOUNT HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRDALE
Mailing Address - State:KY
Mailing Address - Zip Code:40118-9404
Mailing Address - Country:US
Mailing Address - Phone:224-522-1770
Mailing Address - Fax:
Practice Address - Street 1:4523B OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3856
Practice Address - Country:US
Practice Address - Phone:502-966-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY265506237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist