Provider Demographics
NPI:1467821884
Name:PRINCESS A. OTENG
Entity type:Organization
Organization Name:PRINCESS A. OTENG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:A
Authorized Official - Last Name:OTENG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-255-1409
Mailing Address - Street 1:16 N TIMBER HOLLOW DR
Mailing Address - Street 2:APT. 1614
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7769
Mailing Address - Country:US
Mailing Address - Phone:513-255-1409
Mailing Address - Fax:513-795-6406
Practice Address - Street 1:16 N TIMBER HOLLOW DR
Practice Address - Street 2:APT. 1614
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7769
Practice Address - Country:US
Practice Address - Phone:513-255-1409
Practice Address - Fax:513-795-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 368601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health