Provider Demographics
NPI:1275260176
Name:PONGO, BENEDICTA NYARKOA
Entity type:Individual
Prefix:
First Name:BENEDICTA
Middle Name:NYARKOA
Last Name:PONGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BENEDICTA
Other - Middle Name:NYARKOA
Other - Last Name:ASARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 HOLLY SPRINGS PARK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-0719
Mailing Address - Country:US
Mailing Address - Phone:828-349-3550
Mailing Address - Fax:844-560-1102
Practice Address - Street 1:55 HOLLY SPRINGS PARK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-0719
Practice Address - Country:US
Practice Address - Phone:828-349-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program