Healthcare Provider Details

I. General information

NPI: 1649525510
Provider Name (Legal Business Name): VIDA-LYNN ASIAMAH-ASARE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AMARA LN
WESTAMPTON NJ
08060-5753
US

IV. Provider business mailing address

PO BOX 544
RANCOCAS NJ
08073-0544
US

V. Phone/Fax

Practice location:
  • Phone: 609-496-3494
  • Fax:
Mailing address:
  • Phone: 609-496-3494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00382100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP026486
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406109
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00382100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: