Provider Demographics
NPI:1942434097
Name:RUMPH, NIKEISHA TIFFANY (LPN)
Entity Type:Individual
Prefix:MS
First Name:NIKEISHA
Middle Name:TIFFANY
Last Name:RUMPH
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 1:1554 GREENSCAPE BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9513
Mailing Address - Country:US
Mailing Address - Phone:646-228-6492
Mailing Address - Fax:
Practice Address - Street 1:1554 GREENSCAPE BLVD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9513
Practice Address - Country:US
Practice Address - Phone:646-228-6492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.130691-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse