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General NPI Number Information
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NPI Number | 1124317482
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Entity Type | Individual
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Provider Name | NANA YAA ADDO-BOAFO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 351 W CAMDEN ST
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City | BALTIMORE
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State | MD
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Zip | 21201-7912
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Country | US
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Telephone | 513-328-0772
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Fax |
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Provider Business Mailing Address
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Address Line | 853 OAK FOREST DR
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City | MORROW
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State | OH
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Zip | 45152-7914
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Country | US
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Telephone | 513-328-0772
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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 | COA. 17154-NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 336178
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License Number State | OH
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