Healthcare Provider Details

I. General information

NPI: 1508106824
Provider Name (Legal Business Name): FELICIA NTIAMOAH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2498 AGLER RD
COLUMBUS OH
43224-4662
US

IV. Provider business mailing address

1000 MUELLER DR
REYNOLDSBURG OH
43068-9106
US

V. Phone/Fax

Practice location:
  • Phone: 614-332-2791
  • Fax:
Mailing address:
  • Phone: 614-332-2791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0035151
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN.CNP.0035151
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number410855
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: