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General NPI Number Information
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NPI Number | 1679344212
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Entity Type | Individual
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Provider Name | KAKRA GYMFUAA AGYEN
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3009 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45219
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Country | US
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Telephone | 513-872-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E PETE ROSE WAY
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City | CINCINNATI
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State | OH
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Zip | 45202
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Country | US
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Telephone | 407-782-3139
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN.481673
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0037715
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License Number State | OH
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