Provider Demographics
NPI:1174867428
Name:AMPONG, DAVID NANA (DNP)
Entity Type:Individual
Prefix:PROF
First Name:DAVID
Middle Name:NANA
Last Name:AMPONG
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 C ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-5164
Mailing Address - Country:US
Mailing Address - Phone:907-222-2448
Mailing Address - Fax:907-268-6275
Practice Address - Street 1:1577 C ST STE 201
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-5164
Practice Address - Country:US
Practice Address - Phone:907-222-2448
Practice Address - Fax:907-268-6275
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK34122163W00000X
AK136437363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily