Provider Demographics
NPI:1043556871
Name:BOAKYE, STELLA
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:BOAKYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 WEISER CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9388
Mailing Address - Country:US
Mailing Address - Phone:513-907-0193
Mailing Address - Fax:
Practice Address - Street 1:4161 WEISER CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45011-9388
Practice Address - Country:US
Practice Address - Phone:513-330-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400579180107376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide