Provider Demographics
NPI:1023288750
Name:OTENG, LYDIA ACHEAMPONG (RN)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:ACHEAMPONG
Last Name:OTENG
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 1:5260 COVINGTON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7933
Mailing Address - Country:US
Mailing Address - Phone:614-794-0532
Mailing Address - Fax:
Practice Address - Street 1:5260 COVINGTON MEADOWS DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7933
Practice Address - Country:US
Practice Address - Phone:614-794-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse