MEDICARE: NANAABENA TABIRI-GHANSAH

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	163WH0200X	Home Health Registered Nurse	1161524	KY

General Provider Information

NPI Number	:	1548892284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANAABENA TABIRI-GHANSAH

Provider Business Mailing Address
First Line	:	6911 RICHMOND HWY STE 301B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-1846
Country	:	US
Telephone Number	:	571-397-7994
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 RICHMOND HWY STE 301B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-1846
Country	:	US
Telephone Number	:	571-397-7994
Fax Number	:

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

Provider Enumeration Date	:	02/11/2020
Last Update Date	:	02/11/2020

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