Provider Demographics
NPI:1033348677
Name:ANTWI, FLORA ADELAIDE (FNP)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:ADELAIDE
Last Name:ANTWI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3707
Mailing Address - Country:US
Mailing Address - Phone:845-573-9662
Mailing Address - Fax:
Practice Address - Street 1:26 E HICKORY ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-3707
Practice Address - Country:US
Practice Address - Phone:845-573-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335438-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily