Provider Demographics
NPI:1245665751
Name:AMPONSAH, ALFRED (LPN)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:
Last Name:AMPONSAH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 JONES MILL RD APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1284
Mailing Address - Country:US
Mailing Address - Phone:614-592-5235
Mailing Address - Fax:
Practice Address - Street 1:1386 JONES MILL RD APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1284
Practice Address - Country:US
Practice Address - Phone:614-592-5235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.153840-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse