Healthcare Provider Details

I. General information

NPI: 1477029734
Provider Name (Legal Business Name): BIANCA A RAHIM LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7385 BONNIE PL APT 1
YOUNGSTOWN OH
44512-5204
US

IV. Provider business mailing address

7385 BONNIE PL APT 1
YOUNGSTOWN OH
44512-5204
US

V. Phone/Fax

Practice location:
  • Phone: 330-518-8484
  • Fax:
Mailing address:
  • Phone: 330-518-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.169297
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: