Provider Demographics
NPI:1194311308
Name:AKUMAH, KERENHAPPUCH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KERENHAPPUCH
Middle Name:
Last Name:AKUMAH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:PO BOX 1165
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-0165
Mailing Address - Country:US
Mailing Address - Phone:667-678-0508
Mailing Address - Fax:
Practice Address - Street 1:12073 TECH RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7873
Practice Address - Country:US
Practice Address - Phone:301-593-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205347363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health