Healthcare Provider Details

I. General information

NPI: 1457026395
Provider Name (Legal Business Name): HAKIM NURU PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 03/23/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 S MAIN ST STE 440
AKRON OH
44311-4407
US

IV. Provider business mailing address

388 S MAIN ST STE 440
AKRON OH
44311-4407
US

V. Phone/Fax

Practice location:
  • Phone: 330-353-8336
  • Fax: 234-274-8272
Mailing address:
  • Phone: 330-353-8336
  • Fax: 234-274-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.453845
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0030423
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: