Provider Demographics
NPI:1043024086
Name:MCWHORTER, NICOLE MICHELLE (C-CHW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MICHELLE
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:C-CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8139 OLD TROY PIKE # 1083
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-1067
Mailing Address - Country:US
Mailing Address - Phone:513-402-2696
Mailing Address - Fax:
Practice Address - Street 1:8139 OLD TROY PIKE # 1083
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-1067
Practice Address - Country:US
Practice Address - Phone:513-402-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
OHCHW.002748172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoula