Provider Demographics
NPI:1447961271
Name:REMESNIK, NICOLE A (LPN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:REMESNIK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27216 COOK RD TRLR 1
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1087
Mailing Address - Country:US
Mailing Address - Phone:216-258-5892
Mailing Address - Fax:
Practice Address - Street 1:5520 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1606
Practice Address - Country:US
Practice Address - Phone:216-749-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.141724.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty