Organization
PENIEL INTERVENTIONAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELSIE ANTWIWAA TWENEBOAH-KODUAH CRNP, CRNP-PMH (CO-OWNER)
(667) 434-6218
Entity
Organization
Contact information
Practice address
318 SPRY ISLAND RD, JOPPA, MD 21085-5424
(317) 797-9816
Mailing address
318 SPRY ISLAND RD, JOPPA, MD 21085-5424
(317) 797-9816
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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