Provider Demographics
NPI:1457106940
Name:NYARKO, JESSICA OSEI
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:OSEI
Last Name:NYARKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 TAIT RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2531
Mailing Address - Country:US
Mailing Address - Phone:937-830-5465
Mailing Address - Fax:937-249-6427
Practice Address - Street 1:3523 TAIT RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-2531
Practice Address - Country:US
Practice Address - Phone:937-830-5465
Practice Address - Fax:937-249-6427
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH323251771123376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide