Provider Demographics
NPI:1508211541
Name:YEBOAH, EUNICE ASIEDU (CNM)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:ASIEDU
Last Name:YEBOAH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:EUNICE
Other - Middle Name:
Other - Last Name:ASIEDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:908 VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069
Mailing Address - Country:US
Mailing Address - Phone:414-249-0416
Mailing Address - Fax:404-294-1558
Practice Address - Street 1:TRINITAS REGIONAL MEDICAL CENTER
Practice Address - Street 2:225 WILLIAMSON STREET
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202
Practice Address - Country:US
Practice Address - Phone:908-994-5000
Practice Address - Fax:414-906-4533
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148908367A00000X
GARN218856367A00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN258997OtherADVANCED PRACTICE-CNM