Provider Demographics
NPI:1740800168
Name:SIMEI, PASILISAH JEPKOECH
Entity Type:Individual
Prefix:
First Name:PASILISAH
Middle Name:JEPKOECH
Last Name:SIMEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3392 WHISPER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7350
Mailing Address - Country:US
Mailing Address - Phone:614-260-1600
Mailing Address - Fax:
Practice Address - Street 1:3350 CLEVELAND AVE STE 1964
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3677
Practice Address - Country:US
Practice Address - Phone:614-556-8243
Practice Address - Fax:614-523-3388
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH157737164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty