Individual ProviderNicole FasoStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address363 Richland Ave, Apt 259, Athens, OH 45701-3210(716) 785-3733PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Faso does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:10 AM.Profile DetailsProvider ID1275998130Provider TypeIndividualFull NameFaso, NicoleCredentialATGenderFemaleSole ProprietorYesEnumeration Date12/20/2015Last Updated12/20/2015Contact InformationPractice LocationPractice Address363 Richland Ave, Apt 259, Athens, OH 45701-3210Phone(716) 785-3733FaxUnlisted FaxMailing LocationMailing Address363 Richland Ave, Apt 259, Athens, OH 45701-3210PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseAT.004741Ohio