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NPI Code Detail

MEDICARE: MISS TREVA DENISE BAJJOU LPN

MEDICARE: MISS TREVA DENISE BAJJOU LPN
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
1164W00000XLicensed Practical NursePN-113092OH

General Provider Information

NPI Number : 1427276245
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TREVA DENISE BAJJOU LPN
Provider Business Mailing Address
First Line : 1390 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-2767
Country : US
Telephone Number : 614-355-9306
Fax Number : 614-355-9310
Provider Business Practice Location Address
First Line : 1390 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-2767
Country : US
Telephone Number : 614-355-9306
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 08/25/2016

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Directions to “ MISS TREVA DENISE BAJJOU LPN” Practice Location

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