Provider Demographics
NPI:1790342483
Name:ACKAH, AKOSUA A (RN)
Entity Type:Individual
Prefix:MS
First Name:AKOSUA
Middle Name:A
Last Name:ACKAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:AKOSUA
Other - Middle Name:A
Other - Last Name:OWUSU-MENSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2303 HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7292
Mailing Address - Country:US
Mailing Address - Phone:614-517-4398
Mailing Address - Fax:
Practice Address - Street 1:1791 ALUM CREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1757
Practice Address - Country:US
Practice Address - Phone:614-445-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH429009163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty