Individual
FIDELE KOUMANIMBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PN.151506-M-IV
Contact information
Practice address
5254 CAMELOT DR APT D, FAIRFIELD, OH 45014-4022
(513) 497-8095
Mailing address
5254 CAMELOT DR APT D, FAIRFIELD, OH 45014-4022
(513) 497-8095
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.151506-M-IV
OH
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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