Provider Demographics
NPI:1902266703
Name:DUNCAN, EBONI (RN)
Entity Type:Individual
Prefix:
First Name:EBONI
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 FONTAINE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5830
Mailing Address - Country:US
Mailing Address - Phone:614-914-7418
Mailing Address - Fax:
Practice Address - Street 1:3222 FONTAINE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5830
Practice Address - Country:US
Practice Address - Phone:614-914-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH388705163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse