Provider Demographics
NPI:1407287006
Name:NGUEKAM, ANASTASIE WELADJI
Entity Type:Individual
Prefix:
First Name:ANASTASIE
Middle Name:WELADJI
Last Name:NGUEKAM
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 1:20 FOREST PARK DR APT D
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0823
Mailing Address - Country:US
Mailing Address - Phone:513-805-2782
Mailing Address - Fax:
Practice Address - Street 1:20 FOREST PARK DR APT D
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-0823
Practice Address - Country:US
Practice Address - Phone:513-805-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 153189-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse