Provider Demographics
NPI:1518428689
Name:NYARKO, ALBERTA NANA POKUAH
Entity Type:Individual
Prefix:DR
First Name:ALBERTA
Middle Name:NANA POKUAH
Last Name:NYARKO
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 1:415 E RIDGEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5217
Mailing Address - Country:US
Mailing Address - Phone:301-829-2920
Mailing Address - Fax:
Practice Address - Street 1:415 E RIDGEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5217
Practice Address - Country:US
Practice Address - Phone:301-829-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist