Healthcare Provider Details

I. General information

NPI: 1992930119
Provider Name (Legal Business Name): RENEE TWENEBOAH-KODUAH DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW 9TH FLOOR SUITE 9-400 MFA-DEPARTMENT OF NEUROLOGY
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

15530 E.CENTER AVENUE APT#G201
AURORA CO
80017
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2700
  • Fax: 202-741-2722
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1040768
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: