Provider Demographics
NPI:1215811708
Name:GNOFAM, NINKPIBE KEZIA
Entity type:Individual
Prefix:
First Name:NINKPIBE
Middle Name:KEZIA
Last Name:GNOFAM
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 1:63362 195TH ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC JUNCTION
Mailing Address - State:IA
Mailing Address - Zip Code:51561-4037
Mailing Address - Country:US
Mailing Address - Phone:712-302-8075
Mailing Address - Fax:
Practice Address - Street 1:63362 195TH ST
Practice Address - Street 2:
Practice Address - City:PACIFIC JUNCTION
Practice Address - State:IA
Practice Address - Zip Code:51561-4037
Practice Address - Country:US
Practice Address - Phone:712-302-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide