Individual
AGYARE ANTWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
17339 HEATH GROVE LN, RICHMOND, TX 77407-8027
(574) 217-2408
Mailing address
17339 HEATH GROVE LN, RICHMOND, TX 77407-8027
(574) 217-2408
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202205300RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1068282
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202205309NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15535934
CAQH ID
—
05
—
500810911
—
OR
Enumeration date
03/16/2022
Last updated
04/12/2023
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