Provider Demographics
NPI:1720760770
Name:DAILEY-FAIRCHILD, NICOLE EVELIN (CRNA)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:EVELIN
Last Name:DAILEY-FAIRCHILD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 LOGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-8960
Mailing Address - Country:US
Mailing Address - Phone:334-389-0679
Mailing Address - Fax:
Practice Address - Street 1:2440 LOGWOOD CT
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-8960
Practice Address - Country:US
Practice Address - Phone:334-389-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.467962367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered