Provider Demographics
NPI:1124317482
Name:ADDO-BOAFO, NANA YAA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:NANA
Middle Name:YAA
Last Name:ADDO-BOAFO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-7914
Mailing Address - Country:US
Mailing Address - Phone:513-328-0772
Mailing Address - Fax:
Practice Address - Street 1:351 W CAMDEN ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-7912
Practice Address - Country:US
Practice Address - Phone:513-328-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 336178163W00000X
OHCOA. 17154-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse