Provider Demographics
NPI:1780265710
Name:OWUSU, NANA AKUA
Entity type:Individual
Prefix:
First Name:NANA
Middle Name:AKUA
Last Name:OWUSU
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 1:12300 KINGS VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1924
Mailing Address - Country:US
Mailing Address - Phone:240-505-0931
Mailing Address - Fax:410-946-2010
Practice Address - Street 1:12300 KINGS VALLEY CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1924
Practice Address - Country:US
Practice Address - Phone:240-505-0931
Practice Address - Fax:410-946-2010
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00097214376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide