Amanze, Kenny Adeshola
Amanze, Kenny Adeshola is an individual health care provider with primary practice located at 2409 Baikal Loop , Upper Marlboro MD 20774-7051. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Amanze, Kenny Adeshola can be contacted via phone (240) 643-5160.Contact Information
Primary practice address
2409 Baikal Loop
Upper Marlboro MD 20774-7051
Phone: (240) 643-5160
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | R207092 | Maryland |
Profile Details
| NPI number | 1962168468 |
|---|---|
| LBN Legal business name | Amanze, Kenny Adeshola |
| Credentials | CRNP-PHM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2021 |
| Last updated | Nov 10th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962168468 | NPPES |
| Maryland | MEDICAID | 1043645344 | |
| Maryland | MEDICAID | 1083094056 |
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