Provider Demographics
NPI:1861156838
Name:AGYEI, JONATHAN (RN)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:AGYEI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-9695
Mailing Address - Country:US
Mailing Address - Phone:614-352-9344
Mailing Address - Fax:
Practice Address - Street 1:367 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-9695
Practice Address - Country:US
Practice Address - Phone:614-352-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH492182163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty