Provider Demographics
NPI:1437690583
Name:FRIMPONG, KOFI
Entity Type:Individual
Prefix:
First Name:KOFI
Middle Name:
Last Name:FRIMPONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8221 WILLOW OAKS CORPORATE DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4512
Mailing Address - Country:US
Mailing Address - Phone:703-237-9355
Mailing Address - Fax:703-481-3853
Practice Address - Street 1:8221 WILLOW OAKS CORPORATE DR
Practice Address - Street 2:SUITE 450
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4512
Practice Address - Country:US
Practice Address - Phone:703-237-9355
Practice Address - Fax:703-481-3853
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173907363LF0000X
DC1027436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily