Provider Demographics
NPI:1427597251
Name:CHANNELS, SENIKA RANADA
Entity Type:Individual
Prefix:MISS
First Name:SENIKA
Middle Name:RANADA
Last Name:CHANNELS
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 1:17 VANDERBILT DR APT G
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5569
Mailing Address - Country:US
Mailing Address - Phone:614-506-2494
Mailing Address - Fax:937-873-2241
Practice Address - Street 1:17 VANDERBILT DR APT G
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-5569
Practice Address - Country:US
Practice Address - Phone:614-506-2494
Practice Address - Fax:937-873-2241
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH168731164W00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse