Provider Demographics
NPI:1689957177
Name:WENJAH, CECILIA NKENGAFAC
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:NKENGAFAC
Last Name:WENJAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 CHIMNEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-5943
Mailing Address - Country:US
Mailing Address - Phone:614-360-4848
Mailing Address - Fax:
Practice Address - Street 1:2907 CHIMNEY POINT DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-5943
Practice Address - Country:US
Practice Address - Phone:614-360-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400354730404376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide