Provider Demographics
NPI:1487352316
Name:DIAWARA, AWA II
Entity type:Individual
Prefix:MISS
First Name:AWA
Middle Name:
Last Name:DIAWARA
Suffix:II
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AWA
Other - Middle Name:
Other - Last Name:DIAWARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1360 BEECHMEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3856
Mailing Address - Country:US
Mailing Address - Phone:513-661-6077
Mailing Address - Fax:
Practice Address - Street 1:1360 BEECHMEADOW LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3856
Practice Address - Country:US
Practice Address - Phone:513-661-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNUCC3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHW272393962OtherAETNA