Healthcare Provider Details

I. General information

NPI: 1083906390
Provider Name (Legal Business Name): MISS RUTH OWUSU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8846 EAGLEVIEW DR APT 6
WEST CHESTER OH
45069-6715
US

IV. Provider business mailing address

8846 EAGLEVIEW DR APT 6
WEST CHESTER OH
45069-6715
US

V. Phone/Fax

Practice location:
  • Phone: 513-614-6409
  • Fax:
Mailing address:
  • Phone: 513-614-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 378330
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: