Basic Information
| Provider Information | |||||||||
| NPI: | 1609178763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARISH | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | CNP, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636988 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889402722 | ||||||||
| FaxNumber: | 5136328898 | ||||||||
| Practice Location | |||||||||
| Address1: | 1044 BELMONT AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445041006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304803709 | ||||||||
| FaxNumber: | 3304802568 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2010 | ||||||||
| LastUpdateDate: | 10/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | COA.11953-NM | OH | N | Other Service Providers | Midwife | 363LW0102X | COA13218NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 3122669 | 05 | OH | MEDICAID | H003781 | 01 | OH | MEDICARE PTAN | OTHER |