MEDICARE: ADOWA SERWA OSEI NYARKO RN. CCM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	790732	CA
2	163WC0400X	Case Management Registered Nurse	4205479	CA
3	163WC1500X	Community Health Registered Nurse	790732	CA
4	163WH0200X	Home Health Registered Nurse	790732	CA
5	163WH1000X	Hospice Registered Nurse	790732	CA
6	163WP0808X	Psychiatric/Mental Health Registered Nurse	790732	CA
7	163WW0000X	Wound Care Registered Nurse	790732	CA
8	163WA2000X	Administrator Registered Nurse	790732	CA

General Provider Information

NPI Number	:	1245350461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADOWA SERWA OSEI NYARKO RN. CCM

Provider Business Mailing Address
First Line	:	24910 AVENUE TIBBITTS
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-3426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24910 AVENUE TIBBITTS STE 5
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-3426
Country	:	US
Telephone Number	:	661-771-6609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	11/24/2020

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