Provider Demographics
NPI:1275182735
Name:GBOYA, ALIMATU
Entity Type:Individual
Prefix:MISS
First Name:ALIMATU
Middle Name:
Last Name:GBOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6778 GAFFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1280
Mailing Address - Country:US
Mailing Address - Phone:614-749-4627
Mailing Address - Fax:
Practice Address - Street 1:6778 GAFFORD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1280
Practice Address - Country:US
Practice Address - Phone:614-749-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide