MEDICARE: FELISHA EFAW

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	376J00000X	Homemaker		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	:	1841806833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELISHA EFAW

Provider Business Mailing Address
First Line	:	1255 TOWNSHIP ROAD 753
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-9785
Country	:	US
Telephone Number	:	419-685-7363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 TOWNSHIP ROAD 753
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-9785
Country	:	US
Telephone Number	:	419-685-7363
Fax Number	:

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

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	09/16/2020

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Directions to “ FELISHA EFAW ” Practice Location

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