Provider Demographics
NPI:1396329512
Name:NKANSAH-ANDOH, AMA MAAME ANTWIA
Entity type:Individual
Prefix:
First Name:AMA
Middle Name:MAAME ANTWIA
Last Name:NKANSAH-ANDOH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SELINA
Other - Middle Name:ANTWIA
Other - Last Name:OFORI-ATTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 130766
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48113-0766
Mailing Address - Country:US
Mailing Address - Phone:734-330-0223
Mailing Address - Fax:
Practice Address - Street 1:2215 FULLER RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2303
Practice Address - Country:US
Practice Address - Phone:734-845-5768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704227337363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care