Provider Demographics
NPI:1215273644
Name:ADDAE, EUNICE ABENA
Entity type:Individual
Prefix:MS
First Name:EUNICE
Middle Name:ABENA
Last Name:ADDAE
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 1:621 SHARON MILL CT
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4875
Mailing Address - Country:US
Mailing Address - Phone:614-929-9881
Mailing Address - Fax:
Practice Address - Street 1:621 SHARON MILL CT
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4875
Practice Address - Country:US
Practice Address - Phone:614-929-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150556164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse