Provider Demographics
NPI:1033009576
Name:NEALE, NICOLE (DNP, PMHNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:NEALE
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27700 FAIRMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4612
Mailing Address - Country:US
Mailing Address - Phone:330-814-6896
Mailing Address - Fax:
Practice Address - Street 1:20620 JOHN CARROLL BLVD STE 214
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-4540
Practice Address - Country:US
Practice Address - Phone:216-408-7555
Practice Address - Fax:216-424-3239
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0039786363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health