MEDICARE: PEDRO NSOH APESEMAH

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	164W00000X	Licensed Practical Nurse	PN134157-IV	OH

General Provider Information

NPI Number	:	1598038176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO NSOH APESEMAH

Provider Business Mailing Address
First Line	:	5500 CAMELOT DR
Second Line	:	APT #1
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-4089
Country	:	US
Telephone Number	:	513-205-3322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 CAMELOT DR
Second Line	:	APT #1
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-4089
Country	:	US
Telephone Number	:	513-205-3322
Fax Number	:

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

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	02/13/2012

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Directions to “ PEDRO NSOH APESEMAH ” Practice Location

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