Healthcare Provider Details

I. General information

NPI: 1518742212
Provider Name (Legal Business Name): PHINA BASSEY ESSIEN PBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4314 KAYWOOD DR
MOUNT RAINIER MD
20712-1438
US

IV. Provider business mailing address

28 BERWYCK DR
AKRON OH
44312-1102
US

V. Phone/Fax

Practice location:
  • Phone: 330-245-9786
  • Fax:
Mailing address:
  • Phone: 330-245-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: