Provider Demographics
NPI:1275226029
Name:AMANKWAH, FLORA B
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:B
Last Name:AMANKWAH
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 1:921 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-3340
Mailing Address - Country:US
Mailing Address - Phone:732-829-3061
Mailing Address - Fax:
Practice Address - Street 1:4601 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08110-3029
Practice Address - Country:US
Practice Address - Phone:856-663-3405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07406900164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse