Healthcare Provider Details

I. General information

NPI: 1013891233
Provider Name (Legal Business Name): LINDA OWUSUAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 EXECUTIVE PKWY APT 127
WESTERVILLE OH
43081-3854
US

IV. Provider business mailing address

4234 EXECUTIVE PKWY APT 127
WESTERVILLE OH
43081-3854
US

V. Phone/Fax

Practice location:
  • Phone: 380-710-6261
  • Fax:
Mailing address:
  • Phone: 380-710-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.545304
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: