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1306518139 NPI number — FELIX ASIEDU KORANTENG PMHNP

NPI Number: 1306518139
Health Care Provider/Practitioner: FELIX ASIEDU KORANTENG PMHNP

Information about “1306518139” NPI (FELIX ASIEDU KORANTENG PMHNP) exists in 1306518139 in HTML format HTML  |  1306518139 in plain Text format TXT  |  1306518139 in PDF (Portable Document Format) PDF  |  1306518139 in an XML format XML  formats.

NPI Number : 1306518139 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306518139",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KORANTENG",
    "FirstName": "FELIX",
    "MiddleName": "ASIEDU",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ASIEDU",
    "OtherFirstName": "FELIX",
    "OtherMiddleName": "KORANTENG",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "13236 N 7TH ST STE 4",
    "SecondLineMailingAddress": "PMB 366",
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85022-5343",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-782-6988",
    "MailingAddressFaxNumber": "602-782-6989",
    "FirstLinePracticeLocationAddress": "13236 N 7TH ST STE 4",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85022-5343",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-782-6988",
    "PracticeLocationAddressFaxNumber": "602-782-6989",
    "EnumerationDate": "09/30/2021",
    "LastUpdateDate": "08/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WP0809X",
          "TaxonomyName": "Adult Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "222736",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "222736",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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