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General NPI Number Information
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NPI Number | 1093311128
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Entity Type | Individual
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Provider Name | ADWOA ADDO APRN
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Gender | Female
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 4700 ASHWOOD DR STE 200
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City | BLUE ASH
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State | OH
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Zip | 45241-2424
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Country | US
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Telephone | 800-989-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 5726 SUGAR MAPLE RUN
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City | LIBERTY TWP
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State | OH
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Zip | 45011-5957
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Country | US
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Telephone | 513-307-6596
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0028089
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License Number State | OH
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