Individual
MS. KENNY ADESHOLA AMANZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PHM
Contact information
Practice address
915 RHODE ISLAND AVE NW, WASHINGTON, DC 20001-4153
(240) 643-5160
(202) 644-7024
Mailing address
2409 BAIKAL LOOP, UPPER MARLBORO, MD 20774-7051
(240) 643-5160
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP1031662
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R207092
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043645344
—
MD
05
—
1083094056
—
MD
Enumeration date
11/10/2021
Last updated
04/09/2026
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