Provider Demographics
NPI:1801082037
Name:ABANKWAH, ANASTASIA OFEWAA GYESAW (NP)
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:OFEWAA GYESAW
Last Name:ABANKWAH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13330 CHURCH VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7931
Mailing Address - Country:US
Mailing Address - Phone:614-463-0772
Mailing Address - Fax:513-280-8868
Practice Address - Street 1:13330 CHURCH VIEW DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7931
Practice Address - Country:US
Practice Address - Phone:614-463-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH335552163W00000X
KY3009412363L00000X, 363LF0000X
OHCOA.15733-NP363L00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0134038Medicaid
KY7100365600Medicaid
KY7100365600Medicaid