Provider Demographics
NPI:1992531321
Name:KPOBI, DESMOND (LPN)
Entity type:Individual
Prefix:
First Name:DESMOND
Middle Name:
Last Name:KPOBI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3596 SENNA XANDER APT 204
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-0043
Mailing Address - Country:US
Mailing Address - Phone:614-207-4303
Mailing Address - Fax:
Practice Address - Street 1:3596 SENNA XANDER APT 204
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-0043
Practice Address - Country:US
Practice Address - Phone:614-207-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.134467164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse