Provider Demographics
NPI:1699555789
Name:ADDISON, NANCY (RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ADDISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 DICKENS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-6001
Mailing Address - Country:US
Mailing Address - Phone:513-288-8648
Mailing Address - Fax:
Practice Address - Street 1:5375 DICKENS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-6001
Practice Address - Country:US
Practice Address - Phone:513-288-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN203082163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health