Provider Demographics
NPI:1700665395
Name:NACHELLE, AKOSUA AMAKO AFOAKWA (RN)
Entity Type:Individual
Prefix:MRS
First Name:AKOSUA
Middle Name:AMAKO AFOAKWA
Last Name:NACHELLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 W CHARLIE DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85144-0115
Mailing Address - Country:US
Mailing Address - Phone:701-590-4653
Mailing Address - Fax:
Practice Address - Street 1:4499 W CHARLIE DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85144-0115
Practice Address - Country:US
Practice Address - Phone:701-590-4653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ250123163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse