Provider Demographics
NPI:1548710395
Name:CHI, JOAN NJIINTANG (LPN)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:NJIINTANG
Last Name:CHI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:JOAN
Other - Middle Name:NJINTANG
Other - Last Name:MANGOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:8158 MEETING ST APT 105
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6110
Mailing Address - Country:US
Mailing Address - Phone:513-847-8176
Mailing Address - Fax:
Practice Address - Street 1:8158 MEETING ST APT 105
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6110
Practice Address - Country:US
Practice Address - Phone:513-847-8176
Practice Address - Fax:513-847-8176
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162693164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse