Provider Demographics
NPI:1770303430
Name:HALANE, SALMA MOHAMUD
Entity type:Individual
Prefix:MISS
First Name:SALMA
Middle Name:MOHAMUD
Last Name:HALANE
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 1:2513 ADONAI BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6056
Mailing Address - Country:US
Mailing Address - Phone:614-360-7203
Mailing Address - Fax:
Practice Address - Street 1:2513 ADONAI BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-6056
Practice Address - Country:US
Practice Address - Phone:614-360-7203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.172795.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty