Provider Demographics
NPI:1023768934
Name:DUSABE, MARIE JOSIANE
Entity type:Individual
Prefix:MISS
First Name:MARIE JOSIANE
Middle Name:
Last Name:DUSABE
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 1:869 TAMARA DR N
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3273
Mailing Address - Country:US
Mailing Address - Phone:937-797-1508
Mailing Address - Fax:
Practice Address - Street 1:869 TAMARA DR N
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3273
Practice Address - Country:US
Practice Address - Phone:937-797-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty