Healthcare Provider Details

I. General information

NPI: 1922808377
Provider Name (Legal Business Name): ABIGAIL AIDOO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 WAYNE AVE
DAYTON OH
45410-1411
US

IV. Provider business mailing address

PO BOX 746071
ATLANTA GA
30374-6071
US

V. Phone/Fax

Practice location:
  • Phone: 937-348-7001
  • Fax:
Mailing address:
  • Phone: 312-733-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0039309
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP32272
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: