Provider Demographics
NPI:1992173827
Name:KYERAA, PATIENCE
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:KYERAA
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 1:15397 HIGH POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9026
Mailing Address - Country:US
Mailing Address - Phone:614-896-0386
Mailing Address - Fax:
Practice Address - Street 1:15397 HIGH POINTE CIR
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9026
Practice Address - Country:US
Practice Address - Phone:614-896-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401334541211376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide