Healthcare Provider Details

I. General information

NPI: 1588993612
Provider Name (Legal Business Name): MERCY MENSAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERCY Y AGYEI

II. Dates (important events)

Enumeration Date: 12/20/2009
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 POSSUM RUN CT W
COLUMBUS OH
43224-6823
US

IV. Provider business mailing address

4205 POSSUM RUN CT W
COLUMBUS OH
43224-6823
US

V. Phone/Fax

Practice location:
  • Phone: 614-452-3239
  • Fax:
Mailing address:
  • Phone: 614-452-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number501138590606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: