Individual
IDRISS AHMID MANSARAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4175 CARNATION DR, WESTERVILLE, OH 43081-3805
(614) 806-0817
Mailing address
4175 CARNATION DR, WESTERVILLE, OH 43081-3805
(614) 806-0817
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.329693
OH
163WH0200X
Home Health Registered Nurse
RN.329693
OH
163WI0500X
Infusion Therapy Registered Nurse
RN.329693
OH
163WP0200X
Pediatric Registered Nurse
RN.329693
OH
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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