Provider Demographics
NPI:1881192037
Name:OFOSU BUDU, NALLY OTENG (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NALLY
Middle Name:OTENG
Last Name:OFOSU BUDU
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:18444 N 25TH AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1266
Mailing Address - Country:US
Mailing Address - Phone:866-974-2673
Mailing Address - Fax:866-939-2673
Practice Address - Street 1:10494 W THUNDERBIRD BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-6122
Practice Address - Country:US
Practice Address - Phone:866-974-2673
Practice Address - Fax:866-939-2673
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2024-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ6986363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant