Healthcare Provider Details

I. General information

NPI: 1376856112
Provider Name (Legal Business Name): EWURAMA AFADZIWA AMPOFO APRN,NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EWURAMA AFADZIWA HAYFORD APRN, NP-C

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W CENTER ST STE C3
MANCHESTER CT
06040-4870
US

IV. Provider business mailing address

200 W CENTER ST STE C3
MANCHESTER CT
06040-4870
US

V. Phone/Fax

Practice location:
  • Phone: 860-957-8170
  • Fax: 860-969-0929
Mailing address:
  • Phone: 860-712-5956
  • Fax: 860-969-0829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN10033669
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.004400
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10033669
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number12.004400
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: