MEDICARE: MRS. PAULINA OTANG NANYINGAH PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	286636	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1070497	TX
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	215664	OK
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	837312	TX
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	405417	NY
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95024081	CA
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10012972	OR
8	163W00000X	Registered Nurse	837312	TX

General Provider Information

NPI Number	:	1447771696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULINA OTANG NANYINGAH PMHNP

Provider Business Mailing Address
First Line	:	907 MANCHESTER DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-7626
Country	:	US
Telephone Number	:	682-239-3895
Fax Number	:	682-302-9501

Provider Business Practice Location Address
First Line	:	5214F DIAMOND HEIGHTS BLVD # 3422
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2175
Country	:	US
Telephone Number	:	415-360-3348
Fax Number	:	682-302-9501

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

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	03/02/2026

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