Provider Demographics
NPI:1609116607
Name:ELU, KENNETH U (STCNA)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:U
Last Name:ELU
Suffix:
Gender:M
Credentials:STCNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 WALDEN GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1401
Mailing Address - Country:US
Mailing Address - Phone:513-692-5046
Mailing Address - Fax:
Practice Address - Street 1:2315 WALDEN GLEN CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1401
Practice Address - Country:US
Practice Address - Phone:513-692-5046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400187671202376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide