Provider Demographics
NPI:1154100717
Name:RASSAH, GNIKOUMA
Entity type:Individual
Prefix:
First Name:GNIKOUMA
Middle Name:
Last Name:RASSAH
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 1:372 BAVARIAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-3100
Mailing Address - Country:US
Mailing Address - Phone:513-888-0513
Mailing Address - Fax:
Practice Address - Street 1:372 BAVARIAN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-3100
Practice Address - Country:US
Practice Address - Phone:513-888-0513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide