MEDICARE: FATMATA BINTA KANU

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	163WH0500X	Hemodialysis Registered Nurse	00000	OH

General Provider Information

NPI Number	:	1780389692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATMATA BINTA KANU

Provider Business Mailing Address
First Line	:	5803 LOU ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-2908
Country	:	US
Telephone Number	:	614-446-0591
Fax Number	:

Provider Business Practice Location Address
First Line	:	5803 LOU ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-2908
Country	:	US
Telephone Number	:	614-446-0591
Fax Number	:

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

Provider Enumeration Date	:	03/31/2023
Last Update Date	:	03/31/2023

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Directions to “ FATMATA BINTA KANU ” Practice Location

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