Provider Demographics
NPI:1558537993
Name:OWUSU-ANSAH, CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:OWUSU-ANSAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-5003
Mailing Address - Country:US
Mailing Address - Phone:651-501-7983
Mailing Address - Fax:
Practice Address - Street 1:3520 DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-5003
Practice Address - Country:US
Practice Address - Phone:651-501-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-166284-5163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse