Provider Demographics
NPI:1013324185
Name:MENSAH-ADDISON, EBENEZER A (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:EBENEZER
Middle Name:A
Last Name:MENSAH-ADDISON
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 LAKE CLUB DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3198
Mailing Address - Country:US
Mailing Address - Phone:614-322-9210
Mailing Address - Fax:614-322-9214
Practice Address - Street 1:8360 COMSTOCK CT NW
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7675
Practice Address - Country:US
Practice Address - Phone:614-439-1731
Practice Address - Fax:614-322-9214
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.507954163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse