Provider Demographics
NPI:1548892284
Name:TABIRI-GHANSAH, NANAABENA
Entity type:Individual
Prefix:
First Name:NANAABENA
Middle Name:
Last Name:TABIRI-GHANSAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 RICHMOND HWY STE 301B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-1846
Mailing Address - Country:US
Mailing Address - Phone:571-397-7994
Mailing Address - Fax:
Practice Address - Street 1:6911 RICHMOND HWY STE 301B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-1846
Practice Address - Country:US
Practice Address - Phone:571-397-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1161524163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health