Healthcare Provider Details

I. General information

NPI: 1639040181
Provider Name (Legal Business Name): AKOUELE JOSEPHA BURLURAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5370 LESSANDRO ST
SAGINAW MI
48603-3625
US

IV. Provider business mailing address

5370 LESSANDRO ST
SAGINAW MI
48603-3625
US

V. Phone/Fax

Practice location:
  • Phone: 240-547-8341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704392389
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: