Healthcare Provider Details

I. General information

NPI: 1215865720
Provider Name (Legal Business Name): CARE CHOICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 WILLOWBROOK DR
MONROE OH
45050-1755
US

IV. Provider business mailing address

838 WILLOWBROOK DR
MONROE OH
45050-1755
US

V. Phone/Fax

Practice location:
  • Phone: 331-250-2493
  • Fax:
Mailing address:
  • Phone: 331-250-2493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BAKOH MARTILDA AYUKNDANG
Title or Position: OWNER
Credential: CNP
Phone: 331-250-2493