Provider Demographics
NPI:1285967604
Name:OHEMENG, GENEVIEVE (NP)
Entity type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:
Last Name:OHEMENG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:GENEVIEVE
Other - Middle Name:
Other - Last Name:DEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:116 HIGHCREST RD
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4825
Mailing Address - Country:US
Mailing Address - Phone:617-327-6001
Mailing Address - Fax:
Practice Address - Street 1:116 HIGHCREST RD
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-4825
Practice Address - Country:US
Practice Address - Phone:617-327-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN281721163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse