Provider Demographics
NPI:1235875667
Name:AWAH NSOH, VALANTINA
Entity Type:Individual
Prefix:
First Name:VALANTINA
Middle Name:
Last Name:AWAH NSOH
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 1:739 OLD LITTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1968
Mailing Address - Country:US
Mailing Address - Phone:240-557-9784
Mailing Address - Fax:
Practice Address - Street 1:739 OLD LITTLE ROCK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-1968
Practice Address - Country:US
Practice Address - Phone:240-557-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC334446163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy