Provider Demographics
NPI:1457126617
Name:ASARE-KOKOU, ZHANE BRIANNA
Entity Type:Individual
Prefix:
First Name:ZHANE
Middle Name:BRIANNA
Last Name:ASARE-KOKOU
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 1:168 BENELLI DR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-7039
Mailing Address - Country:US
Mailing Address - Phone:786-618-4787
Mailing Address - Fax:
Practice Address - Street 1:168 BENELLI DR
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-7039
Practice Address - Country:US
Practice Address - Phone:786-618-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026658363LF0000X
SC27787363LF0000X
GANP001668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily