Provider Demographics
NPI:1477815892
Name:ENOW, KINGSLEY EYONG (NP)
Entity Type:Individual
Prefix:
First Name:KINGSLEY
Middle Name:EYONG
Last Name:ENOW
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 E LIVINGSTON AVE STE G
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2252
Mailing Address - Country:US
Mailing Address - Phone:614-715-8216
Mailing Address - Fax:614-715-8239
Practice Address - Street 1:3505 E LIVINGSTON AVE STE G
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2252
Practice Address - Country:US
Practice Address - Phone:614-632-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0031826363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health