Healthcare Provider Details

I. General information

NPI: 1053589317
Provider Name (Legal Business Name): ESTHER YEBOAH-AWUSI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BLAIR MILL RD STE. 400
HORSHAM PA
19044-2223
US

IV. Provider business mailing address

680 BLAIR MILL RD STE. 400
HORSHAM PA
19044-2223
US

V. Phone/Fax

Practice location:
  • Phone: 267-965-7962
  • Fax:
Mailing address:
  • Phone: 267-965-7962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008097
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: