Healthcare Provider Details

I. General information

NPI: 1063016624
Provider Name (Legal Business Name): BERNICE OFORI ATTAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 NILLES RD
FAIRFIELD OH
45014-3878
US

IV. Provider business mailing address

1095 NILLES RD
FAIRFIELD OH
45014-3878
US

V. Phone/Fax

Practice location:
  • Phone: 513-206-6045
  • Fax: 513-829-2373
Mailing address:
  • Phone: 513-206-6045
  • Fax: 513-829-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0906256
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number0906256
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number0906256
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: