Provider Demographics
NPI:1083342893
Name:AMANKWA, PATRICIA KONADU (PMHNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KONADU
Last Name:AMANKWA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WHITESTONE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-8023
Mailing Address - Country:US
Mailing Address - Phone:703-203-2136
Mailing Address - Fax:
Practice Address - Street 1:32 WHITESTONE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-8023
Practice Address - Country:US
Practice Address - Phone:703-203-2136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00244184615363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health