Provider Demographics
NPI:1508604372
Name:KABOI, LYVEEN S
Entity type:Individual
Prefix:
First Name:LYVEEN
Middle Name:S
Last Name:KABOI
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 1:5607 CREEKSIDE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0755
Mailing Address - Country:US
Mailing Address - Phone:513-816-6363
Mailing Address - Fax:
Practice Address - Street 1:5607 CREEKSIDE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-0755
Practice Address - Country:US
Practice Address - Phone:513-816-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118369164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse