Healthcare Provider Details

I. General information

NPI: 1518192129
Provider Name (Legal Business Name): ANTHONIA NZIKA LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4290 MACSWAY AVE
COLUMBUS OH
43232-4257
US

IV. Provider business mailing address

4290 MACSWAY AVE
COLUMBUS OH
43232-4257
US

V. Phone/Fax

Practice location:
  • Phone: 614-937-2314
  • Fax:
Mailing address:
  • Phone: 614-937-2314
  • Fax: 614-863-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0035450
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.373372
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN128658
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: