Provider Demographics
NPI:1083597454
Name:AMPEM, NANA SERWAA (PMHNP)
Entity type:Individual
Prefix:
First Name:NANA
Middle Name:SERWAA
Last Name:AMPEM
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 GRIFFIS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5919
Mailing Address - Country:US
Mailing Address - Phone:513-307-4810
Mailing Address - Fax:
Practice Address - Street 1:5132 GRIFFIS LAKE DR
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-5919
Practice Address - Country:US
Practice Address - Phone:513-307-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2025027528363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health