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Individual

FAVOUR GRACE NGANJE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4076 ELAINE CT, COLUMBUS, OH 43227-5602
(614) 735-1746
Mailing address
4076 ELAINE CT, COLUMBUS, OH 43227-5602
(614) 735-1746

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
155987
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3049418
MEDICARE, INDEPENDENT PROVIDER
OH
Enumeration date
05/05/2014
Last updated
09/25/2014
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