Provider Demographics
NPI:1861210957
Name:OPOKU, NANA
Entity type:Individual
Prefix:
First Name:NANA
Middle Name:
Last Name:OPOKU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 ADIRONDACK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-3122
Mailing Address - Country:US
Mailing Address - Phone:908-499-4834
Mailing Address - Fax:
Practice Address - Street 1:3106 ADIRONDACK AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-3122
Practice Address - Country:US
Practice Address - Phone:908-499-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide