Provider Demographics
NPI:1396013512
Name:GICHUKI, ANN WAITHERA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:WAITHERA
Last Name:GICHUKI
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 1:3527 GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3447
Mailing Address - Country:US
Mailing Address - Phone:571-501-0972
Mailing Address - Fax:
Practice Address - Street 1:3527 GREENWICH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3447
Practice Address - Country:US
Practice Address - Phone:571-501-0972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146252164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse