Provider Demographics
NPI:1801441084
Name:OTENG, ABENA ADOMA (NP, RN)
Entity type:Individual
Prefix:
First Name:ABENA
Middle Name:ADOMA
Last Name:OTENG
Suffix:
Gender:F
Credentials:NP, RN
Other - Prefix:
Other - First Name:ABENA
Other - Middle Name:ADOMA
Other - Last Name:NUAMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP,RN
Mailing Address - Street 1:5354 BILBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8400
Mailing Address - Country:US
Mailing Address - Phone:978-235-1354
Mailing Address - Fax:
Practice Address - Street 1:5354 BILBERRY LN
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8400
Practice Address - Country:US
Practice Address - Phone:978-235-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2325948163WP0809X
OH0030941363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult