Provider Demographics
NPI:1144182627
Name:KYEI-SAMPONG, PRISCILLA
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:KYEI-SAMPONG
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 1:692 BREVARD CIR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7875
Mailing Address - Country:US
Mailing Address - Phone:614-962-4746
Mailing Address - Fax:614-962-4746
Practice Address - Street 1:692 BREVARD CIR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7875
Practice Address - Country:US
Practice Address - Phone:614-962-4746
Practice Address - Fax:614-962-4746
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH495936163WP0808X, 163WX0800X, 163WH0200X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical