Provider Demographics
NPI:1053622415
Name:BAAH, ABENA FOSUAH (NONE)
Entity type:Individual
Prefix:MISS
First Name:ABENA
Middle Name:FOSUAH
Last Name:BAAH
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 GREENBROOK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-1830
Mailing Address - Country:US
Mailing Address - Phone:614-218-0471
Mailing Address - Fax:
Practice Address - Street 1:3233 GREENBROOK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-1830
Practice Address - Country:US
Practice Address - Phone:614-218-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN135016164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse