Elsie Antwiwaa Tweneboah-Koduah, DNP,CRNP,PMHNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R209129 Issued in MD

Practice address

317 Spry Island Rd
Joppa, MD 21085-5425

Phone

(667) 434-6218

NPI assigned

Mar 27, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peniel Interventional Care

  • Psychiatric/Mental Health Nurse Practitioner
  • Joppa, MD
  • NPI 1962234849
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1134680648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 SPRY ISLAND RD",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210855424",
            "telephone_number": "317-797-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 SPRY ISLAND RD",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210855425",
            "telephone_number": "667-434-6218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1952 Pulaski Hwy",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "MD",
            "postal_code": "210401658",
            "country_code": "US",
            "telephone_number": "410-676-1463",
            "fax_number": "410-676-0864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Barrington Pl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210145607",
            "country_code": "US",
            "telephone_number": "410-676-1463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TWENEBOAH-KODUAH",
        "first_name": "ELSIE",
        "middle_name": "ANTWIWAA",
        "credential": "DNP,CRNP,PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R209129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald E Thomas, MD
• Lidwine Tohounde
• Christine Tolliver, MS, CCC-SLP
• Trans Personal Phychological Services, Inc
• Triumph Primary Care LLC
• Walgreen Co
• Walgreen Co.
• Chantel Walker
• Laurice White
• Wilbrinas Medical Services

• Family Nurse Practitioner in Joppa, MD
• Providers in Joppa, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.