Provider Demographics
NPI:1184338568
Name:ASOBO, EMILIEN SHURI
Entity type:Individual
Prefix:
First Name:EMILIEN
Middle Name:SHURI
Last Name:ASOBO
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 1:3896 SUMMIT POINTE APT 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7696
Mailing Address - Country:US
Mailing Address - Phone:978-398-1771
Mailing Address - Fax:
Practice Address - Street 1:3896 SUMMIT POINTE APT 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-7696
Practice Address - Country:US
Practice Address - Phone:978-398-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty