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NPI Code Detail

MEDICARE: MANNACARE HEALTH AND WELLNESS MEDICAL CENTER LLC

MEDICARE: MANNACARE HEALTH AND WELLNESS MEDICAL CENTER LLC
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 Practitioner

General Provider Information

NPI Number : 1649821158
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANNACARE HEALTH AND WELLNESS MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 3101 W ELM ST STE 300
Second Line :
City : LIMA
State : OH
Zip : 45805-2555
Country : US
Telephone Number : 419-673-7754
Fax Number :
Provider Business Practice Location Address
First Line : 3101 W ELM ST STE 300
Second Line :
City : LIMA
State : OH
Zip : 45805-2555
Country : US
Telephone Number : 419-673-7754
Fax Number : 419-458-2165
Authorized Official
Title or Position : MANAGER
Name : ABIGAIL AKYEAMPONG
Credential : NP
Telephone Number : 419-673-7754
Provider Enumeration Date : 09/25/2019
Last Update Date : 09/11/2025

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Directions to “MANNACARE HEALTH AND WELLNESS MEDICAL CENTER LLC ” Practice Location

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