Provider Demographics
NPI:1518729425
Name:KOUASSI, FERNAND
Entity type:Individual
Prefix:MR
First Name:FERNAND
Middle Name:
Last Name:KOUASSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6033 BEAR CREEK DR APT 205
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2912
Mailing Address - Country:US
Mailing Address - Phone:330-842-5767
Mailing Address - Fax:
Practice Address - Street 1:6033 BEAR CREEK DR APT 205
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-2912
Practice Address - Country:US
Practice Address - Phone:330-842-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker