Provider Demographics
NPI:1497053821
Name:MABHENA-OFORI, NDANDA ANNETTE (RN, MSN, NP)
Entity Type:Individual
Prefix:MRS
First Name:NDANDA
Middle Name:ANNETTE
Last Name:MABHENA-OFORI
Suffix:
Gender:F
Credentials:RN, MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 NEWELL ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5313
Mailing Address - Country:US
Mailing Address - Phone:315-798-9300
Mailing Address - Fax:
Practice Address - Street 1:807 NEWELL ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5313
Practice Address - Country:US
Practice Address - Phone:315-798-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008653363L00000X
NY306289363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner