Healthcare Provider Details

I. General information

NPI: 1932018363
Provider Name (Legal Business Name): MARTINA ADWOA POKUA ACHANFUO-YEBOAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

PO BOX 1839
BLOOMFIELD NJ
07003-1839
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-3339
  • Fax:
Mailing address:
  • Phone: 973-391-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR19515000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: