Provider Demographics
NPI:1275260176
Name:PONGO, BENEDICTA NYARKOA
Entity Type:Individual
Prefix:
First Name:BENEDICTA
Middle Name:NYARKOA
Last Name:PONGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BENEDICTA
Other - Middle Name:NYARKOA
Other - Last Name:ASARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:TREVECCA NAZARENE UNIV PA PROGRAM 333 MURFREESBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210
Mailing Address - Country:US
Mailing Address - Phone:615-248-1225
Mailing Address - Fax:
Practice Address - Street 1:TREVECCA NAZARENE UNIV PA PROGRAM 333 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210
Practice Address - Country:US
Practice Address - Phone:615-248-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program