Provider Demographics
NPI:1063011401
Name:OTTOPAH, JOSEPHINE OWUSUAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:OWUSUAH
Last Name:OTTOPAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 AMELIA TRL
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-7712
Mailing Address - Country:US
Mailing Address - Phone:501-499-2532
Mailing Address - Fax:
Practice Address - Street 1:12195 SINGLETREE LN
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-4214
Practice Address - Country:US
Practice Address - Phone:952-829-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-17
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1246741835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist