Provider Demographics
NPI:1902145428
Name:BOATENG, HENRIETTA ATTAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HENRIETTA
Middle Name:ATTAH
Last Name:BOATENG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 FREEDOM DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2816
Mailing Address - Country:US
Mailing Address - Phone:704-399-3955
Mailing Address - Fax:
Practice Address - Street 1:15918 UMBRELLA LN
Practice Address - Street 2:APT. 304
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7722
Practice Address - Country:US
Practice Address - Phone:704-654-6614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist