Kenesha E Djalal, LICENSED NURSE

Individual provider Active NPI Licensed Practical Nurse · Trotwood, OH

NPI 1831831908 · NPPES record last updated Apr 10, 2022

Key facts

NPI
1831831908
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
138436 (OH)
Practice address
5377 Salem Bend Dr Apt C
Trotwood, OH 45426-1635
Phone
(326) 467-2878
NPI assigned
Apr 10, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
138436OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 138436 OH Yes

Addresses

Primary practice location

5377 Salem Bend Dr Apt C
Trotwood, OH 45426-1635

Mailing address

5377 Salem Bend Dr Apt C
Trotwood, OH 45426-1635
Phone (326) 467-2878

Other providers in Trotwood, OH

All providers in Trotwood, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.