Provider Demographics
NPI:1669725917
Name:KONTEH, ONDINE NGWASHI NGOSSA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ONDINE NGWASHI
Middle Name:NGOSSA
Last Name:KONTEH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1002
Mailing Address - Country:US
Mailing Address - Phone:614-645-2700
Mailing Address - Fax:614-645-2727
Practice Address - Street 1:1500 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1002
Practice Address - Country:US
Practice Address - Phone:614-645-2700
Practice Address - Fax:614-645-2727
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA13807-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0097359Medicaid
OHH275290Medicare PIN