Provider Demographics
NPI:1689145013
Name:ASIEDU, EBENEZER AKOI (APRN)
Entity Type:Individual
Prefix:
First Name:EBENEZER
Middle Name:AKOI
Last Name:ASIEDU
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S LUDLOW ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2610
Mailing Address - Country:US
Mailing Address - Phone:937-208-2004
Mailing Address - Fax:937-208-8828
Practice Address - Street 1:721 MIAMI CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4650
Practice Address - Country:US
Practice Address - Phone:937-281-6900
Practice Address - Fax:937-208-8828
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023301363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health