Healthcare Provider Details

I. General information

NPI: 1285811703
Provider Name (Legal Business Name): CYNTHIA AMMA NKANSAH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA AMMA AKU CRNA

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

3100 SPRING FOREST RD SUITE 130
RALEIGH NC
27616-2880
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-3138
  • Fax:
Mailing address:
  • Phone: 919-882-0705
  • Fax: 919-873-9821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0001187472
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024167664
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: