| Koann Therapeutic Services Inc | |
|
845 N Main St Providence RI 02904-5700 | |
| (401) 648-7172 | |
| (401) 648-0161 |
| Full Name | Koann Therapeutic Services Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 845 N Main St, Providence, Rhode Island |
| Authorized Official Name and Position | Akos Antwi (PROVIDER/CEO) |
| Authorized Official Contact | 4016487172 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Koann Therapeutic Services Inc Po Box 3085 Pawtucket RI 02861-0585 Ph: () - | Koann Therapeutic Services Inc 845 N Main St Providence RI 02904-5700 Ph: (401) 648-7172 |
| NPI Number | 1639843303 |
|---|---|
| Provider Enumeration Date | 08/05/2021 |
| Last Update Date | 10/30/2024 |
| Medicare PECOS PAC ID | 7113302282 |
|---|---|
| Medicare Enrollment ID | O20220912000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639843303 | NPI | - | NPPES |
| Provider Name | Akos Antwi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760966436 PECOS PAC ID: 9436567617 Enrollment ID: I20210428001981 |
| Provider Name | Molly Anne Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336442540 PECOS PAC ID: 3870779416 Enrollment ID: I20210818001556 |
| Provider Name | Christina Onassis Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285297689 PECOS PAC ID: 6709264542 Enrollment ID: I20220607000405 |
| Provider Name | Joshua Jackson Selly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205594579 PECOS PAC ID: 5890210835 Enrollment ID: I20250422003056 |
| Provider Name | Kaitlin Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508503012 PECOS PAC ID: 1759807175 Enrollment ID: I20250429002277 |
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