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General NPI Number Information
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NPI Number | 1336715416
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Entity Type | Individual
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Provider Name | SETH OWUSU-KWARTENG CRNP
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Gender | Male
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Dates
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Enumeration Date | 05/31/2021
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Last Update Date | 03/03/2024
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Provider Practice Location Address
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Address Line | 9300 DEWITT LOOP
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5285
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Country | US
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Telephone | 571-231-4689
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Fax |
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Provider Business Mailing Address
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Address Line | 10920 MERIDIAN HILL WAY
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-4068
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Country | US
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Telephone | 301-523-6354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R210600
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License Number State | MD
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