Healthcare Provider Details

I. General information

NPI: 1619254315
Provider Name (Legal Business Name): HARRIET S. KIGANDA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HARRIET S LULE RN

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 06/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6795 GAINES RD
CINCINNATI OH
45247-5857
US

IV. Provider business mailing address

6795 GAINES RD
CINCINNATI OH
45247-5857
US

V. Phone/Fax

Practice location:
  • Phone: 513-593-4900
  • Fax: 513-386-7410
Mailing address:
  • Phone: 513-593-4900
  • Fax: 513-386-7410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number253501
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number253501
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: