Provider Demographics
NPI:1487984381
Name:MBAH, USMAN M (LPN)
Entity type:Individual
Prefix:MR
First Name:USMAN
Middle Name:M
Last Name:MBAH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22807 SPELLBROOK BEND LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-6397
Mailing Address - Country:US
Mailing Address - Phone:513-307-7700
Mailing Address - Fax:513-332-9050
Practice Address - Street 1:22807 SPELLBROOK BEND LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-6397
Practice Address - Country:US
Practice Address - Phone:513-307-7700
Practice Address - Fax:513-332-9050
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138622164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse