Provider Demographics
NPI:1568620987
Name:BOAKYE, FREDA AMOAA
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:AMOAA
Last Name:BOAKYE
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 1:5117 WINTON RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2990
Mailing Address - Country:US
Mailing Address - Phone:513-829-2348
Mailing Address - Fax:
Practice Address - Street 1:5117 WINTON RD
Practice Address - Street 2:UNIT A
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2990
Practice Address - Country:US
Practice Address - Phone:513-829-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.321384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse