Provider Demographics
NPI:1336962588
Name:OBENG, AUGUSTINE NYAMEKYE
Entity type:Individual
Prefix:
First Name:AUGUSTINE
Middle Name:NYAMEKYE
Last Name:OBENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5291
Mailing Address - Country:US
Mailing Address - Phone:513-823-8591
Mailing Address - Fax:
Practice Address - Street 1:17 APPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5291
Practice Address - Country:US
Practice Address - Phone:513-823-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN175242MEDSIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse