Provider Demographics
NPI:1598038176
Name:APESEMAH, PEDRO NSOH
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:NSOH
Last Name:APESEMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:PEDRO
Other - Middle Name:NSOH
Other - Last Name:APESEMAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:5500 CAMELOT DR
Mailing Address - Street 2:APT #1
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4089
Mailing Address - Country:US
Mailing Address - Phone:513-205-3322
Mailing Address - Fax:
Practice Address - Street 1:5500 CAMELOT DR
Practice Address - Street 2:APT #1
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-4089
Practice Address - Country:US
Practice Address - Phone:513-205-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN134157-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse