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General NPI Number Information
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NPI Number | 1174074025
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Entity Type | Individual
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Provider Name | AFFI ALLADO-ANKA PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/16/2016
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 650 JOEL DR
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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Country | US
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Telephone | 270-956-5218
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1094
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-7094
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Country | US
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Telephone | 270-956-2185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0006919
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License Number State | MD
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