Provider Demographics
NPI:1629100490
Name:AKABUTU, KENNETH K K (LPN)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:K K
Last Name:AKABUTU
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 FARMBROOK LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1572
Mailing Address - Country:US
Mailing Address - Phone:614-275-2072
Mailing Address - Fax:
Practice Address - Street 1:3898 FARMBROOK LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1572
Practice Address - Country:US
Practice Address - Phone:614-275-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN121801251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care