MEDICARE: KATE OBY OKOH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	UE321506	OH

General Provider Information

NPI Number	:	1396231114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE OBY OKOH

Provider Business Mailing Address
First Line	:	9708 DEER TRACK RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-7047
Country	:	US
Telephone Number	:	513-805-2777
Fax Number	:

Provider Business Practice Location Address
First Line	:	9708 DEER TRACK RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-7047
Country	:	US
Telephone Number	:	513-805-2777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2018
Last Update Date	:	11/08/2018

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