Provider Demographics
NPI:1902369168
Name:MENSAH, NANA A (FNP, AANP)
Entity Type:Individual
Prefix:
First Name:NANA
Middle Name:A
Last Name:MENSAH
Suffix:
Gender:F
Credentials:FNP, AANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 OLNEY SANDY SPRING RD STE 140
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1494
Mailing Address - Country:US
Mailing Address - Phone:301-570-6245
Mailing Address - Fax:240-389-1888
Practice Address - Street 1:3300 OLNEY SANDY SPRING RD STE 140
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1494
Practice Address - Country:US
Practice Address - Phone:301-570-6245
Practice Address - Fax:240-389-1888
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF04190068363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
F04190068OtherF04190068