Healthcare Provider Details

I. General information

NPI: 1295399665
Provider Name (Legal Business Name): HUFSAH AKBAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 S NEW BALLAS RD
SAINT LOUIS MO
63141-8704
US

IV. Provider business mailing address

1548 HANNA RD
VALLEY PARK MO
63088-2301
US

V. Phone/Fax

Practice location:
  • Phone: 314-432-5144
  • Fax:
Mailing address:
  • Phone: 773-454-5326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAG02190116
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: