Healthcare Provider Details

I. General information

NPI: 1003359944
Provider Name (Legal Business Name): HILDA NKANSAH FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2016
Last Update Date: 11/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE SUITE 10Q
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

530 1ST AVE SUITE 10Q
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number340793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: