Provider Demographics
NPI:1124268271
Name:ADDAI-ACHAMPONG, CHRISTOS (RN)
Entity type:Individual
Prefix:MR
First Name:CHRISTOS
Middle Name:
Last Name:ADDAI-ACHAMPONG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:KAYENTA
Mailing Address - State:AZ
Mailing Address - Zip Code:86033-0368
Mailing Address - Country:US
Mailing Address - Phone:928-672-3000
Mailing Address - Fax:
Practice Address - Street 1:HWY 98 & NAVAJO RT 16
Practice Address - Street 2:INSCRIPTION HOUSE HEALTH CENTER
Practice Address - City:TONALEA
Practice Address - State:AZ
Practice Address - Zip Code:86044
Practice Address - Country:US
Practice Address - Phone:928-672-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN072717163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ060012Medicaid
AZ060012Medicaid
AZ030073Medicare Oscar/Certification