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General NPI Number Information
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NPI Number | 1922620624
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Entity Type | Individual
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Provider Name | HAROLD KWEKU BEDU-ADDO
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Gender | Male
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 1546 BERRY BLVD STE B
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City | LOUISVILLE
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State | KY
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Zip | 40215-1955
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Country | US
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Telephone | 502-823-2579
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Fax |
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Provider Business Mailing Address
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Address Line | 156 MOUNTAIN STONE CT
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-7732
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Country | US
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Telephone | 614-218-2947
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1114681
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License Number State | KY
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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 | 3016409
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License Number State | KY
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