Susan Nchimunya Bauleni, LPN

Individual provider Active NPI Licensed Practical Nurse · Stow, OH

NPI 1891053013 · NPPES record last updated Apr 25, 2012

Key facts

NPI
1891053013
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN 148406 (OH)
Practice address
2093 Darrow Lake Dr
Stow, OH 44224-6081
Phone
(216) 482-6672
NPI assigned
Apr 25, 2012
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
PN 148406OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 148406 OH Yes

Addresses

Primary practice location

2093 Darrow Lake Dr
Stow, OH 44224-6081

Mailing address

2093 Darrow Lake Dr
Stow, OH 44224-6081
Phone (216) 482-6672

Other providers in Stow, OH

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

Sources for this page

Verify at the official NPI Registry.