Provider Demographics
NPI:1023728854
Name:IVENSO, KATE CHINWE
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:CHINWE
Last Name:IVENSO
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 1:2502 QUEEN CITY AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2924
Mailing Address - Country:US
Mailing Address - Phone:513-824-0418
Mailing Address - Fax:
Practice Address - Street 1:2502 QUEEN CITY AVE APT 5
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2924
Practice Address - Country:US
Practice Address - Phone:513-824-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty