Provider Demographics
NPI:1689027633
Name:KUM, CLEOPATRA (RN)
Entity Type:Individual
Prefix:
First Name:CLEOPATRA
Middle Name:
Last Name:KUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5874 ASHLYN CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9327
Mailing Address - Country:US
Mailing Address - Phone:513-348-6214
Mailing Address - Fax:
Practice Address - Street 1:5874 ASHLYN CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9327
Practice Address - Country:US
Practice Address - Phone:513-348-6214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN416384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse