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General NPI Number Information
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NPI Number | 1598593287
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Entity Type | Individual
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Provider Name | ESTHER POKUAA ADU NP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 610 N MICHIGAN ST STE 400
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City | SOUTH BEND
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State | IN
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Zip | 46601-1081
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Country | US
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Telephone | 574-647-3437
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Fax |
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Provider Business Mailing Address
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Address Line | 3245 HEALTH DRIVE SUITE 100
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City | MISHAWAKA
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State | IN
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Zip | 46545-3700
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Country | US
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Telephone | 574-647-3437
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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 | 71015616A
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License Number State | IN
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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 | 28237426A
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License Number State | IN
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