Healthcare Provider Details

I. General information

NPI: 1407237167
Provider Name (Legal Business Name): PATRICIA KANTU ADAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA KANTU GOMA

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 E GALBRAITH RD STE 105
CINCINNATI OH
45236-6706
US

IV. Provider business mailing address

4750 E GALBRAITH RD STE 105
CINCINNATI OH
45236-6706
US

V. Phone/Fax

Practice location:
  • Phone: 513-981-4444
  • Fax: 513-686-4217
Mailing address:
  • Phone: 513-981-4444
  • Fax: 513-686-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.17522
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: