Basic Information
| Provider Information | |||||||||
| NPI: | 1467645234 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIMPONG-BADU | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | NANA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5656 KELLEY ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770261967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135665600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5656 KELLEY ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770261967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135665600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2007 | ||||||||
| LastUpdateDate: | 05/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 735840 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 193781502 | 01 | TX | CSHCN | OTHER | 193781801 | 05 | TX | MEDICAID | 8L3417 | 01 | TX | MEDICARE PTAN | OTHER | 8Y4058 | 01 | TX | BCBSTX | OTHER |