MEDICARE: YVONNE NKAFU FOMENKY CNP, RHIA, RN

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	RN289586	OH
2	363LF0000X	Family Nurse Practitioner	COA.15966-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568437648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE NKAFU FOMENKY CNP, RHIA, RN

Provider Business Mailing Address
First Line	:	2336 MINERVA PARK PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4770
Country	:	US
Telephone Number	:	614-946-3022
Fax Number	:	614-392-1083

Provider Business Practice Location Address
First Line	:	2336 MINERVA PARK PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4770
Country	:	US
Telephone Number	:	614-946-3022
Fax Number	:	614-392-1083

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	12/29/2014

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