Individual
AMIRRA S UMPENHOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3042 MCKINLEY AVE, COLUMBUS, OH 43204-3653
(614) 487-7805
(614) 487-7809
Mailing address
8243 SEA STAR DR, BLACKLICK, OH 43004-8229
(304) 614-9208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
169348
OH
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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