Provider Demographics
NPI:1164119566
Name:NKAMDJO NKAMSE, CORINE SONIA (RN)
Entity Type:Individual
Prefix:
First Name:CORINE SONIA
Middle Name:
Last Name:NKAMDJO NKAMSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 GRAYLAKE CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8891
Mailing Address - Country:US
Mailing Address - Phone:614-316-9924
Mailing Address - Fax:
Practice Address - Street 1:2434 GRAYLAKE CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8891
Practice Address - Country:US
Practice Address - Phone:614-316-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.499729163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse