Provider Demographics
NPI:1164717492
Name:OWUSU, PRISCILLA NANA AMA (MD)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:NANA AMA
Last Name:OWUSU
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:904 LILY CREEK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2818
Mailing Address - Country:US
Mailing Address - Phone:502-357-3900
Mailing Address - Fax:502-323-0377
Practice Address - Street 1:904 LILY CREEK RD STE 201
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:KY
Practice Address - Zip Code:40243-2818
Practice Address - Country:US
Practice Address - Phone:502-357-3900
Practice Address - Fax:502-323-0377
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY46878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine