Provider Demographics
NPI:1790427946
Name:MUHAMMAD, AYONNA MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:AYONNA
Middle Name:MARIE
Last Name:MUHAMMAD
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 1:7033 TREEBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1537
Mailing Address - Country:US
Mailing Address - Phone:740-314-2245
Mailing Address - Fax:
Practice Address - Street 1:1380 DUBLIN RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1025
Practice Address - Country:US
Practice Address - Phone:614-488-7117
Practice Address - Fax:614-488-7118
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN156395164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse