Provider Demographics
NPI:1639940794
Name:FLAKWAH, EMMANUELLA A (RN)
Entity Type:Individual
Prefix:
First Name:EMMANUELLA
Middle Name:A
Last Name:FLAKWAH
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 1:1 LUNNEY CT APT 204
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6060
Mailing Address - Country:US
Mailing Address - Phone:845-521-5529
Mailing Address - Fax:
Practice Address - Street 1:1 LUNNEY CT APT 204
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-6060
Practice Address - Country:US
Practice Address - Phone:845-521-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY902960163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical