MEDICARE: ALHAGIE EBRIHIM JOBARTEH CNP

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.023409	OH

General Provider Information

NPI Number	:	1891260139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALHAGIE EBRIHIM JOBARTEH CNP

Provider Business Mailing Address
First Line	:	2780 AIRPORT DR
Second Line	:	STE 100
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2289
Country	:	US
Telephone Number	:	614-645-5500
Fax Number	:	614-645-5517

Provider Business Practice Location Address
First Line	:	4661 SAWMILL RD STE 101
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-6123
Country	:	US
Telephone Number	:	614-526-3285
Fax Number	:	614-526-3286

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

Provider Enumeration Date	:	10/12/2018
Last Update Date	:	03/22/2021

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