Provider Demographics
NPI:1639489768
Name:PANKEY, ANITA JOEL (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ANITA
Middle Name:JOEL
Last Name:PANKEY
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 1:3680 KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-3344
Mailing Address - Country:US
Mailing Address - Phone:614-783-8756
Mailing Address - Fax:614-725-0945
Practice Address - Street 1:3680 KIRKWOOD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-3344
Practice Address - Country:US
Practice Address - Phone:614-783-8756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
OH400445700105376K00000X
OHPN 1319973164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide