Provider Demographics
NPI:1952803801
Name:OUR UNIQUE ANGELS NURSING CARE
Entity Type:Organization
Organization Name:OUR UNIQUE ANGELS NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPN
Authorized Official - Prefix:
Authorized Official - First Name:MARKIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNIST
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:513-706-9767
Mailing Address - Street 1:3180 PRESERVE LN APT 3C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6913
Mailing Address - Country:US
Mailing Address - Phone:513-706-9767
Mailing Address - Fax:513-706-9767
Practice Address - Street 1:6240 HAMILTON AVE STE 6C
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224
Practice Address - Country:US
Practice Address - Phone:513-327-8202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160522251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160522OtherLICENSED PRACTICAL NURSE