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General NPI Number Information
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NPI Number | 1265165237
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Entity Type | Individual
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Provider Name | NANA YAA AGYEIWAA ANOKWAA AMPAW MBCHB
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5189
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Country | US
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Telephone | 800-836-7536
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Fax |
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Provider Business Mailing Address
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Address Line | 1922 W OGDEN AVE UNIT 1616
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City | CHICAGO
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State | IL
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Zip | 60612-5586
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Country | US
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Telephone | 443-613-9094
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125079798
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MT233240
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License Number State | PA
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