1184429466 NPI number — NORDYKE HEALTH LLC

Table of content: MS. AMBER MICHELLE LITHILA FNP (NPI 1467961748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184429466 NPI number — NORDYKE HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORDYKE HEALTH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184429466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8107 WOODCREEK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41042-9595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-380-9191
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8044 MONTGOMERY RD STE 700
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45236-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-440-3866
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NORDYKE
Authorized Official First Name:
ZACHARY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
513-623-8422

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)