MEDICARE: MS. PHINA BASSEY ESSIEN PBE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	376J00000X	Homemaker	OH
2	172V00000X	Community Health Worker
3	3747P1801X	Personal Care Attendant	OH

General Provider Information

NPI Number	:	1518742212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PHINA BASSEY ESSIEN PBE

Provider Business Mailing Address
First Line	:	28 BERWYCK DR
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-1102
Country	:	US
Telephone Number	:	330-245-9786
Fax Number	:

Provider Business Practice Location Address
First Line	:	4314 KAYWOOD DR
Second Line	:
City	:	MOUNT RAINIER
State	:	MD
Zip	:	20712-1438
Country	:	US
Telephone Number	:	330-245-9786
Fax Number	:

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

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	05/05/2026

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