Individual ProviderKwesi ImmanuelRegistered NurseNursing Service ProvidersPractice Address3104 E Camelback Rd # 2412, Phoenix, AZ 85016-4502(520) 371-0846PECOS EnrollmentBased on the most recent information from CMS, provider Kwesi Immanuel does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1952267775Provider TypeIndividualFull NameImmanuel, KwesiGenderMaleSole ProprietorYesEnumeration Date12/26/2025Last Updated12/26/2025Contact InformationPractice LocationPractice Address3104 E Camelback Rd # 2412, Phoenix, AZ 85016-4502Phone(520) 371-0846FaxUnlisted FaxMailing LocationMailing Address3104 E Camelback Rd # 2412, Phoenix, AZ 85016-4502PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense254947Arizona