Healthcare Provider Details

I. General information

NPI: 1295968113
Provider Name (Legal Business Name): GLORIA OPOKU-GYAMFI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 05/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 E DUBLIN GRANVILLE RD # 318
COLUMBUS OH
43229-3508
US

IV. Provider business mailing address

1933 E DUBLIN GRANVILLE RD # 318
COLUMBUS OH
43229-3508
US

V. Phone/Fax

Practice location:
  • Phone: 614-962-1914
  • Fax: 614-735-7655
Mailing address:
  • Phone: 614-962-1914
  • Fax: 614-735-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN288898
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: