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General NPI Number Information
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NPI Number | 1376182725
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Entity Type | Individual
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Provider Name | BRIANA RENOIS ANTWI NP
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Gender | Female
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 23 BUSTLETON PIKE
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City | FEASTERVILLE TREVOSE
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State | PA
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Zip | 19053-6446
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Country | US
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Telephone | 215-464-0770
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Fax | 267-579-0720
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Provider Business Mailing Address
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Address Line | 7836 PENROSE AVE APT B
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City | ELKINS PARK
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State | PA
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Zip | 19027-1024
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Country | US
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Telephone | 917-588-8492
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN700326
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP020982
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License Number State | PA
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