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NPI Code Detail

MEDICARE: MRS. FELICIA AMOAH BOADU APRN

MEDICARE: MRS. FELICIA AMOAH BOADU APRN
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
1363LF0000XFamily Nurse Practitioner11002381FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376061846
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FELICIA AMOAH BOADU APRN
Provider Business Mailing Address
First Line : 17589 COL RANCH DR
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-7085
Country : US
Telephone Number : 646-696-1550
Fax Number :
Provider Business Practice Location Address
First Line : 195 PAGE MILL RD STE 103
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-2073
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2017
Last Update Date : 01/07/2026

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