Healthcare Provider Details

I. General information

NPI: 1073808697
Provider Name (Legal Business Name): AMOAFI SEFA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2011
Last Update Date: 06/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 MESA RIDGE LN
COLUMBUS OH
43231-6731
US

IV. Provider business mailing address

5520 MESA RIDGE LN
COLUMBUS OH
43231-6731
US

V. Phone/Fax

Practice location:
  • Phone: 614-328-6876
  • Fax:
Mailing address:
  • Phone: 614-328-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.369290
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: