Healthcare Provider Details

I. General information

NPI: 1497134746
Provider Name (Legal Business Name): JOYCE KAHTUMA WANYAM ATENCHONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOYCE KAHTUMA WANYAM ATENCHONG PMHNP-BC

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 HIGH ST NE
WARREN OH
44481-1222
US

IV. Provider business mailing address

320 HIGH ST NE
WARREN OH
44481-1222
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-9090
  • Fax:
Mailing address:
  • Phone: 330-394-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0041637
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: