MEDICARE: KWESI LEE KORANTENG IMMANUEL PMHNP

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	254947	AZ

General Provider Information

NPI Number	:	1952267775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWESI LEE KORANTENG IMMANUEL PMHNP

Provider Business Mailing Address
First Line	:	818 E WILEY WAY
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-1218
Country	:	US
Telephone Number	:	520-371-0846
Fax Number	:

Provider Business Practice Location Address
First Line	:	818 E WILEY WAY
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-1218
Country	:	US
Telephone Number	:	520-371-0846
Fax Number	:

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

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	06/09/2026

Similar Medicare Providers

1295666824 — GREATER GOOD WELLNESS PLLC
Practice Location Address:

818 E WILEY WAY
CASA GRANDE, AZ
85122-1218

Practice Phone: 520-371-0846
Practice Fax:

1275885006 — SACRED SOULS HOME HEALTH CARE LLC
Practice Location Address:

8115 RIO GRANDE BLVD NW
LOS RANCHOS, NM
87114-1218

Practice Phone: 505-730-0356
Practice Fax:

1982605887 — RAJEESH S PUNNAKKATTU MD
Practice Location Address:

1780 E FLORENCE BLVD STE 110
CASA GRANDE, AZ
85122-4782

Practice Phone: 520-374-8915
Practice Fax: 520-233-7015

1588142368 — LUCERO ELIZABETH VALENZUELA
Practice Location Address:

1627 E WALTER DR
CASA GRANDE, AZ
85122-5915

Practice Phone: 480-612-4912
Practice Fax:

1265124697 — MR. KUNAL DEORA M.D
Practice Location Address:

1800 E FLORENCE BLVD
CASA GRANDE, AZ
85122-5303

Practice Phone: 520-381-6300
Practice Fax:

1447184981 — MARISOL REYES
Practice Location Address:

312 W 10TH ST STE 2
CASA GRANDE, AZ
85122-3940

Practice Phone: 520-222-7385
Practice Fax:

Directions to “ KWESI LEE KORANTENG IMMANUEL PMHNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.