Individual
AGNES TAKEM TAKANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6089 SANDGATE RD, COLUMBUS, OH 43229-2716
(614) 357-3799
Mailing address
6089 SANDGATE RD, COLUMBUS, OH 43229-2716
(614) 357-3799
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
163982
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163982
LPN
OH
Enumeration date
10/12/2021
Last updated
10/12/2021
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