Healthcare Provider Details

I. General information

NPI: 1467920934
Provider Name (Legal Business Name): MAAME EKUA OSEI DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 E ALESSANDRO BLVD
RIVERSIDE CA
92508-6071
US

IV. Provider business mailing address

491 E ALESSANDRO BLVD
RIVERSIDE CA
92508-6071
US

V. Phone/Fax

Practice location:
  • Phone: 951-780-1835
  • Fax:
Mailing address:
  • Phone: 951-780-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number767334
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95010962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: