Provider Demographics
NPI:1508039611
Name:TABI NSIAH, NANA KYEREWA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANA
Middle Name:KYEREWA
Last Name:TABI NSIAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NANA
Other - Middle Name:KYEREWA
Other - Last Name:AMPOFO-TWUMASI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:414-454-6753
Mailing Address - Fax:414-454-6600
Practice Address - Street 1:1220 DEWEY AVENUE
Practice Address - Street 2:AURORA BEHAVIORAL HEALTH SERVICES
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213
Practice Address - Country:US
Practice Address - Phone:414-454-6754
Practice Address - Fax:414-454-6600
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350974032084P0800X
390200000X
WI56885202084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100030578Medicaid