Healthcare Provider Details

I. General information

NPI: 1205765195
Provider Name (Legal Business Name): ANITA AKUAMOAH ABANKWAH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 NORFOLK ST
WORCESTER MA
01604-2960
US

IV. Provider business mailing address

86 NORFOLK ST
WORCESTER MA
01604-2960
US

V. Phone/Fax

Practice location:
  • Phone: 860-803-5874
  • Fax:
Mailing address:
  • Phone: 860-803-5874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2389777
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: