Provider Demographics
NPI:1093746869
Name:KWATENG, JANET A (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:A
Last Name:KWATENG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 SABALWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7153
Mailing Address - Country:US
Mailing Address - Phone:156-149-9022
Mailing Address - Fax:
Practice Address - Street 1:225 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4616
Practice Address - Country:US
Practice Address - Phone:561-274-3100
Practice Address - Fax:561-274-3144
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1469252363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL034250500Medicaid
FLAK9294527OtherPRESCRIPTION
P54188Medicare UPIN
E7123AMedicare ID - Type Unspecified