Provider Demographics
NPI:1861627150
Name:ACQUAH, GRACE AMMA (RN)
Entity Type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:AMMA
Last Name:ACQUAH
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 1:1860 MORRIS AVE
Mailing Address - Street 2:APT. 2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-6249
Mailing Address - Country:US
Mailing Address - Phone:347-330-1792
Mailing Address - Fax:
Practice Address - Street 1:1860 MORRIS AVE
Practice Address - Street 2:APT. 2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-6249
Practice Address - Country:US
Practice Address - Phone:347-330-1792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY624782-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse