Provider Demographics
NPI:1518413202
Name:ENOCH, MI-LEE NGUYEN
Entity Type:Individual
Prefix:
First Name:MI-LEE
Middle Name:NGUYEN
Last Name:ENOCH
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 1:4409 COLERAIN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1216
Mailing Address - Country:US
Mailing Address - Phone:513-580-2616
Mailing Address - Fax:
Practice Address - Street 1:4409 COLERAIN AVE APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1216
Practice Address - Country:US
Practice Address - Phone:513-580-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCMS H8953018Medicare PIN