Provider Demographics
NPI:1568508232
Name:NOTOMA, RUTH ONOME (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ONOME
Last Name:NOTOMA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 ROTHROCK DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8693
Mailing Address - Country:US
Mailing Address - Phone:614-853-4474
Mailing Address - Fax:
Practice Address - Street 1:849 ROTHROCK DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8693
Practice Address - Country:US
Practice Address - Phone:614-853-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.106248164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse