MEDICARE: MRS. ANTHONIA NZIKA LPN

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	163W00000X	Registered Nurse	RN.373372	OH
2	164W00000X	Licensed Practical Nurse	PN128658	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0035450	OH

General Provider Information

NPI Number	:	1518192129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANTHONIA NZIKA LPN

Provider Business Mailing Address
First Line	:	4290 MACSWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4257
Country	:	US
Telephone Number	:	614-937-2314
Fax Number	:	614-863-9601

Provider Business Practice Location Address
First Line	:	4290 MACSWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4257
Country	:	US
Telephone Number	:	614-937-2314
Fax Number	:

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

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	01/17/2024

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