Individual
AMINATA FOFANAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1649 BRICE RD, REYNOLDSBURG, OH 43068-2758
(614) 300-5878
Mailing address
4186 BRACKENWOOD TRL, COLUMBUS, OH 43228-8440
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0029676
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.0029676
NP
OH
Enumeration date
09/27/2021
Last updated
09/30/2024
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