Provider Demographics
NPI:1851898209
Name:ANTWI, ELVI A (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELVI
Middle Name:A
Last Name:ANTWI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-6908
Mailing Address - Country:US
Mailing Address - Phone:410-660-3963
Mailing Address - Fax:
Practice Address - Street 1:3046 HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-6908
Practice Address - Country:US
Practice Address - Phone:410-660-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008807363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care