MEDICARE: HAROLD KWEKU BEDU-ADDO

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	163W00000X	Registered Nurse	1114681	KY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3016409	KY

General Provider Information

NPI Number	:	1922620624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD KWEKU BEDU-ADDO

Provider Business Mailing Address
First Line	:	156 MOUNTAIN STONE CT
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-7732
Country	:	US
Telephone Number	:	614-218-2947
Fax Number	:

Provider Business Practice Location Address
First Line	:	1546 BERRY BLVD STE B
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40215-1955
Country	:	US
Telephone Number	:	502-823-2579
Fax Number	:

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

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	06/16/2026

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