Healthcare Provider Details

I. General information

NPI: 1033617709
Provider Name (Legal Business Name): FEVEN FIKRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 SPRINGOAK LN
PICKERINGTON OH
43147-7888
US

IV. Provider business mailing address

3611 SPRINGOAK LN
PICKERINGTON OH
43147-7888
US

V. Phone/Fax

Practice location:
  • Phone: 614-806-2888
  • Fax:
Mailing address:
  • Phone: 614-806-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number439048
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: