Organization
IANUA HEALTH, LLC
Active
Other names
KetaMinds
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO PEDULLA JR. FNP (OWNER)
(610) 998-3902
Entity
Organization
Contact information
Practice address
14 ROGERS RD STE 211, NORTH EAST, MD 21901-3612
(410) 280-7683
Mailing address
2207 CONCORD PIKE # 197, WILMINGTON, DE 19803-2908
(610) 998-3902
(610) 702-8056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2022
Last updated
05/17/2023
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