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Individual

NKENGAFAC ETCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP, FNP

Contact information

Practice address
1251 W BROAD ST, COLUMBUS, OH 43222-1359
(614) 584-4270
Mailing address
313 MARJORAM DR, GAHANNA, OH 43230-7027
(614) 584-4270

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
393025
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.024052
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1376969204
CENTERS FOR MEDICARE AND MEDICAID SERVICES
OH
Enumeration date
03/17/2014
Last updated
01/13/2023
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