Provider Demographics
NPI:1750121927
Name:ALSAEEDI, SURA A (HOME HEALTH AID)
Entity type:Individual
Prefix:MISS
First Name:SURA
Middle Name:A
Last Name:ALSAEEDI
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 PUNDERSON DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8664
Mailing Address - Country:US
Mailing Address - Phone:614-779-5998
Mailing Address - Fax:
Practice Address - Street 1:2497 PUNDERSON DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8664
Practice Address - Country:US
Practice Address - Phone:614-779-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide