Provider Demographics
NPI:1548872385
Name:AKROFI, CANUELLA SERWAH
Entity type:Individual
Prefix:
First Name:CANUELLA
Middle Name:SERWAH
Last Name:AKROFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 CHERRY HILL RD APT 1112
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1254
Mailing Address - Country:US
Mailing Address - Phone:202-509-2662
Mailing Address - Fax:
Practice Address - Street 1:1232 RACE ROAD
Practice Address - Street 2:STE 403
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-2123
Practice Address - Country:US
Practice Address - Phone:443-868-7101
Practice Address - Fax:443-732-0054
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN215739363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily