Provider Demographics
NPI:1164912887
Name:EKEH, PRECIOUS (LPN)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:EKEH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 JULIE CRES
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-4908
Mailing Address - Country:US
Mailing Address - Phone:631-332-4567
Mailing Address - Fax:
Practice Address - Street 1:22 JULIE CRES
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-4908
Practice Address - Country:US
Practice Address - Phone:631-332-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK66538164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse