Healthcare Provider Details

I. General information

NPI: 1992694616
Provider Name (Legal Business Name): FRIDA JABEA NGALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 DOGWOOD DR APT F
COLUMBUS OH
43228-3770
US

IV. Provider business mailing address

3815 DOGWOOD DR APT F
COLUMBUS OH
43228-3770
US

V. Phone/Fax

Practice location:
  • Phone: 563-422-0143
  • Fax:
Mailing address:
  • Phone: 563-422-0143
  • Fax: 563-422-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: