Basic Information
| Provider Information | |||||||||
| NPI: | 1063605244 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABUNAW | ||||||||
| FirstName: | GLORIA | ||||||||
| MiddleName: | AMEH | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6400 E BROAD ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432132979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6146553345 | ||||||||
| FaxNumber: | 6143174689 | ||||||||
| Practice Location | |||||||||
| Address1: | 8100 RAVINES EDGE CT STE 200 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432355426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6146553345 | ||||||||
| FaxNumber: | 6143174689 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 09/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | LP43641 | MD | N | Nursing Service Providers | Licensed Practical Nurse | 163W00000X | RN.445127 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.