Provider Demographics
NPI:1306518139
Name:KORANTENG, FELIX ASIEDU (PMHNP)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:ASIEDU
Last Name:KORANTENG
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:FELIX
Other - Middle Name:KORANTENG
Other - Last Name:ASIEDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1050 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-7187
Mailing Address - Country:US
Mailing Address - Phone:480-593-7109
Mailing Address - Fax:
Practice Address - Street 1:1050 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-7187
Practice Address - Country:US
Practice Address - Phone:480-593-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ222736163WP0809X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult