Provider Demographics
NPI:1265228316
Name:KHUON, SOKUNTHEA
Entity type:Individual
Prefix:
First Name:SOKUNTHEA
Middle Name:
Last Name:KHUON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 S WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3237
Mailing Address - Country:US
Mailing Address - Phone:614-516-3867
Mailing Address - Fax:
Practice Address - Street 1:252 S WAYNE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3237
Practice Address - Country:US
Practice Address - Phone:614-516-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide