Healthcare Provider Details

I. General information

NPI: 1558601096
Provider Name (Legal Business Name): ADANNE O INYIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1369 TWELVE OAKS CT
BLACKLICK OH
43004-7503
US

IV. Provider business mailing address

1369 TWELVE OAKS CT
BLACKLICK OH
43004-7503
US

V. Phone/Fax

Practice location:
  • Phone: 240-898-7144
  • Fax:
Mailing address:
  • Phone: 202-299-1109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042576
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: