Provider Demographics
NPI:1992292395
Name:OWUSU, MAYFRED (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MAYFRED
Middle Name:
Last Name:OWUSU
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE.
Mailing Address - Street 2:PULMONARY TCC ML 11024
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-803-0375
Mailing Address - Fax:513-803-1124
Practice Address - Street 1:3333 BURNET AVE.
Practice Address - Street 2:PULMONARY TCC ML 11024
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-803-0375
Practice Address - Fax:513-803-1124
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF0316308363LP0200X
OHAPRN.CNP.19114363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics