Provider Demographics
NPI:1407842370
Name:WILSON-KUMI, NAA ADAAWAH (CRNA)
Entity type:Individual
Prefix:MS
First Name:NAA
Middle Name:ADAAWAH
Last Name:WILSON-KUMI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-3231
Mailing Address - Country:US
Mailing Address - Phone:240-899-1993
Mailing Address - Fax:
Practice Address - Street 1:56 FRANKLIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1281
Practice Address - Country:US
Practice Address - Phone:203-709-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN-197396367500000X
DCRN966002367500000X
CT109131367500000X
CT005239367500000X
COSRA25033367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKBC1CHOtherCAREFIRST BCBS
MDP00745078OtherMEDICARE RAILROAD
COP00956867OtherMEDICARE RR
DCS417-0022OtherCAREFIRST BCBS
MD404579300Medicaid
CO82681279Medicaid
MDP00745078OtherMEDICARE RAILROAD
COCOA102637Medicare PIN