Provider Demographics
NPI:1477399095
Name:KORANTENG, HARRISON (PMHNP)
Entity type:Individual
Prefix:MR
First Name:HARRISON
Middle Name:
Last Name:KORANTENG
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MIDWESTERN PKWY E
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-2302
Mailing Address - Country:US
Mailing Address - Phone:940-766-8868
Mailing Address - Fax:940-766-8681
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-766-8868
Practice Address - Fax:940-766-8681
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1159747363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health