Provider Demographics
NPI:1700013257
Name:AKABUAKU, NGOZI C
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:C
Last Name:AKABUAKU
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 1:234 PLAYERS CLUB CT
Mailing Address - Street 2:
Mailing Address - City:COMMERCIAL POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43116-9700
Mailing Address - Country:US
Mailing Address - Phone:614-446-0102
Mailing Address - Fax:614-860-0106
Practice Address - Street 1:234 PLAYERS CLUB CT
Practice Address - Street 2:
Practice Address - City:COMMERCIAL POINT
Practice Address - State:OH
Practice Address - Zip Code:43116-9700
Practice Address - Country:US
Practice Address - Phone:614-446-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.110267-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2604720Medicaid