Individual
NANA NIMAKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-8509
Mailing address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-8509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR24466400
NJ
163W00000X
Registered Nurse
653943
NY
363L00000X
Nurse Practitioner
26NJ01428100
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
F383484
NY
Other
Enumeration date
09/20/2012
Last updated
09/24/2024
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