Provider Demographics
NPI:1659195808
Name:NTUNDU, PAULINE K
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:K
Last Name:NTUNDU
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 1:6025 BOYMEL DR APT B
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8523
Mailing Address - Country:US
Mailing Address - Phone:309-230-9103
Mailing Address - Fax:
Practice Address - Street 1:11875 SHENANDOAH TRCE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7115
Practice Address - Country:US
Practice Address - Phone:513-479-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker