MEDICARE: LYDIA OPOKU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver
2	3747P1801X	Personal Care Attendant
3	374J00000X	Doula
4	376J00000X	Homemaker
5	385H00000X	Respite Care
6	163W00000X	Registered Nurse	RN534402	OH

General Provider Information

NPI Number	:	1245048339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA OPOKU

Provider Business Mailing Address
First Line	:	2376 MINERVA PARK PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4770
Country	:	US
Telephone Number	:	614-371-9683
Fax Number	:

Provider Business Practice Location Address
First Line	:	2376 MINERVA PARK PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4770
Country	:	US
Telephone Number	:	614-371-9683
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2024
Last Update Date	:	01/23/2025

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Directions to “ LYDIA OPOKU ” Practice Location

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