MEDICARE: FIDELIA ADOMAKO ASANTE-ANSONG NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10020621	OR
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95028512	CA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	328453	AZ
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1138239	TX
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010622	DE
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	12168	MN
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	120916	WV
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024189063	VA

General Provider Information

NPI Number	:	1134909450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FIDELIA ADOMAKO ASANTE-ANSONG NP

Provider Business Mailing Address
First Line	:	27922 COLONIAL POINT DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-3712
Country	:	US
Telephone Number	:	703-732-1182
Fax Number	:

Provider Business Practice Location Address
First Line	:	27922 COLONIAL POINT DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-3712
Country	:	US
Telephone Number	:	703-732-1182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	12/09/2025

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