Provider Demographics
NPI:1457637795
Name:CEESAY, FATOU O (RN)
Entity Type:Individual
Prefix:
First Name:FATOU
Middle Name:O
Last Name:CEESAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 E DUBLIN GRANVILLE RD STE 321
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3314
Mailing Address - Country:US
Mailing Address - Phone:614-599-7512
Mailing Address - Fax:
Practice Address - Street 1:1395 E DUBLIN GRANVILLE RD STE 321
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3314
Practice Address - Country:US
Practice Address - Phone:614-599-7512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.438885163WH0200X, 163W00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH831329544Medicaid