Healthcare Provider Details

I. General information

NPI: 1790425106
Provider Name (Legal Business Name): ERNEST TAWIAH OSEI-OWUSU LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 WATSON LANE MIDDLETOWN
MIDDLETOWN DE
19709
US

IV. Provider business mailing address

27 WATSON LANE MIDDLETOWN
MIDDLETOWN DE
19709
US

V. Phone/Fax

Practice location:
  • Phone: 302-981-9187
  • Fax:
Mailing address:
  • Phone: 302-981-9187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL2-0011827
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: