Provider Demographics
NPI:1659042927
Name:ASARE, ADWOA NKYIRAH (NURSE)
Entity Type:Individual
Prefix:
First Name:ADWOA
Middle Name:NKYIRAH
Last Name:ASARE
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SEVER ST # 4
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2104
Mailing Address - Country:US
Mailing Address - Phone:774-386-1801
Mailing Address - Fax:
Practice Address - Street 1:8 SEVER ST # 4
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2104
Practice Address - Country:US
Practice Address - Phone:774-386-1801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN87556164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALN87556OtherNURSING LICENSE