Samuel Agyenim Boateng, CNP
Nurse Practitioner, Family in Reynoldsburg, OH. Individual provider (NPI-1).
NPI number1033740824
StatusActive
Last updated in NPPESJan 30, 2020
Details
- NPI
- 1033740824
- Entity type
- Individual (NPI-1)
- Name
- Mr. Samuel Agyenim Boateng
- Credential
- CNP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 30, 2020
- Certification date
- Jan 30, 2020
- Last updated
- Jan 30, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN.CNP.025942 | OH | Yes |
Practice location
Holy Hills Healthcare Services, LLC6760 Tussing Road Suite 104
Reynoldsburg, OH 43068-4136
Phone 614-626-6000 · Fax 614-577-0807
Mailing address
144 Brandywine Dr Apt BWesterville, OH 43081-1379
Phone 614-806-8865
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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