Provider Demographics
NPI:1871048306
Name:RANKINS, NICOLE RENEE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:RENEE
Last Name:RANKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 SUNSET AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3152
Mailing Address - Country:US
Mailing Address - Phone:513-227-2521
Mailing Address - Fax:
Practice Address - Street 1:1872 SUNSET AVE
Practice Address - Street 2:APT 2
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3182
Practice Address - Country:US
Practice Address - Phone:513-227-2521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH155690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse