Provider Demographics
NPI:1588255988
Name:HAMISI, CHISEKO
Entity type:Individual
Prefix:MISS
First Name:CHISEKO
Middle Name:
Last Name:HAMISI
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 1:588 EVERGREEN TER
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-5231
Mailing Address - Country:US
Mailing Address - Phone:614-425-1502
Mailing Address - Fax:
Practice Address - Street 1:588 EVERGREEN TER
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-5231
Practice Address - Country:US
Practice Address - Phone:614-425-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00033648363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty