Provider Demographics
NPI:1720731631
Name:BANAHENE, BENEDICTA ASARE (NP)
Entity type:Individual
Prefix:
First Name:BENEDICTA
Middle Name:ASARE
Last Name:BANAHENE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 LOCKMEAD CT
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7364
Mailing Address - Country:US
Mailing Address - Phone:614-446-8675
Mailing Address - Fax:
Practice Address - Street 1:909 LOCKMEAD CT
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7364
Practice Address - Country:US
Practice Address - Phone:614-446-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030774363LF0000X
OH2021160494363LF0000X
OH363266163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator