Provider Demographics
NPI:1750172664
Name:PETRON, NICHOL
Entity type:Individual
Prefix:
First Name:NICHOL
Middle Name:
Last Name:PETRON
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 1:2522 EASTGATE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1533
Mailing Address - Country:US
Mailing Address - Phone:330-999-1998
Mailing Address - Fax:
Practice Address - Street 1:2522 EASTGATE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1533
Practice Address - Country:US
Practice Address - Phone:330-999-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker