Provider Demographics
NPI:1336493907
Name:NDONUE, JUSTINE LEM
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:LEM
Last Name:NDONUE
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 1:5095 CEDAR DR APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2793
Mailing Address - Country:US
Mailing Address - Phone:301-523-4150
Mailing Address - Fax:
Practice Address - Street 1:5095 CEDAR DR APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2793
Practice Address - Country:US
Practice Address - Phone:301-523-4150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.149100164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse