MEDICARE: FELIX ASIEDU KORANTENG PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	222736	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	222736	AZ

General Provider Information

NPI Number	:	1306518139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELIX ASIEDU KORANTENG PMHNP

Provider Business Mailing Address
First Line	:	13236 N 7TH ST STE 4
Second Line	:	PMB 366
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5343
Country	:	US
Telephone Number	:	602-782-6988
Fax Number	:	602-782-6989

Provider Business Practice Location Address
First Line	:	13236 N 7TH ST STE 4
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5343
Country	:	US
Telephone Number	:	602-782-6988
Fax Number	:	602-782-6989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2021
Last Update Date	:	08/14/2025

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