MEDICARE: PATRICIA WAIRIMU KIBUI RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN 113108	OH

General Provider Information

NPI Number	:	1396917308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA WAIRIMU KIBUI RN

Provider Business Mailing Address
First Line	:	1418 SHARON BROOK CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229
Country	:	US
Telephone Number	:	614-270-0638
Fax Number	:

Provider Business Practice Location Address
First Line	:	2983 BLACKBIRD CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-5029
Country	:	US
Telephone Number	:	614-475-9051
Fax Number	:	614-475-9051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	09/14/2017

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