Provider Demographics
NPI:1609504745
Name:AWUAH OTCHERE, PRINCESS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PRINCESS
Middle Name:
Last Name:AWUAH OTCHERE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 E BLUFF VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-7070
Mailing Address - Country:US
Mailing Address - Phone:909-991-6334
Mailing Address - Fax:
Practice Address - Street 1:6079 N FRESNO ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5276
Practice Address - Country:US
Practice Address - Phone:559-538-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95123366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily