Provider Demographics
NPI:1407173461
Name:FELICIA EBAI
Entity Type:Organization
Organization Name:FELICIA EBAI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EBAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-309-5224
Mailing Address - Street 1:5748 STAGHORN DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4561
Mailing Address - Country:US
Mailing Address - Phone:419-309-5224
Mailing Address - Fax:
Practice Address - Street 1:5748 STAGHORN DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-4561
Practice Address - Country:US
Practice Address - Phone:419-309-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN130986 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty