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NPI Code Detail

MEDICARE: JANE KOROMA MSN

MEDICARE: JANE KOROMA MSN
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.026464OH
2163W00000XRegistered NurseRN.389299OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477905461
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE KOROMA MSN
Provider Business Mailing Address
First Line : 50 N WILSON RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1214
Country : US
Telephone Number : 614-702-7915
Fax Number : 614-965-6534
Provider Business Practice Location Address
First Line : 50 N WILSON RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1214
Country : US
Telephone Number : 614-702-7915
Fax Number : 614-965-6534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 06/09/2022

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