Healthcare Provider Details

I. General information

NPI: 1730585027
Provider Name (Legal Business Name): MUMINATU SESAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1342 BARNES DR
COLUMBUS OH
43229-1389
US

IV. Provider business mailing address

1342 BARNES DR
COLUMBUS OH
43229-1389
US

V. Phone/Fax

Practice location:
  • Phone: 614-779-7054
  • Fax: 614-707-7150
Mailing address:
  • Phone: 614-779-7054
  • Fax: 614-707-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401375320412
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: