Provider Demographics
NPI:1760651871
Name:UME-LOVE, CHICHI SABINAH
Entity type:Individual
Prefix:MISS
First Name:CHICHI
Middle Name:SABINAH
Last Name:UME-LOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHINELO
Other - Middle Name:
Other - Last Name:UME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2347 CLYBOURNE ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231
Mailing Address - Country:US
Mailing Address - Phone:614-478-4538
Mailing Address - Fax:614-478-4537
Practice Address - Street 1:AN2347 CLYBOURNE ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231
Practice Address - Country:US
Practice Address - Phone:614-478-4538
Practice Address - Fax:614-478-4537
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 129105 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2585242Medicaid