MEDICARE: STEPHANIE TAKOUKAM NJOUONANG

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	376K00000X	Nurse's Aide	401111370710	OH

General Provider Information

NPI Number	:	1407122161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE TAKOUKAM NJOUONANG

Provider Business Mailing Address
First Line	:	1310 CHESTERWOOD CT
Second Line	:	A
City	:	CINCINNATI
State	:	OH
Zip	:	45246-2761
Country	:	US
Telephone Number	:	513-284-8276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 CHESTERWOOD CT
Second Line	:	A
City	:	CINCINNATI
State	:	OH
Zip	:	45246-2761
Country	:	US
Telephone Number	:	513-284-8276
Fax Number	:

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

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	04/02/2012

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