Healthcare Provider Details

I. General information

NPI: 1740511948
Provider Name (Legal Business Name): IDA AGYEI AYENSU APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IDA APPIAH-AGYEI NP

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4837
  • Fax: 614-293-3125
Mailing address:
  • Phone: 614-293-4837
  • Fax: 614-293-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.11811
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.11811
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: