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General NPI Number Information
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NPI Number | 1225715931
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Entity Type | Individual
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Provider Name | ABLAVI AKPENE KOUTA
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Gender | Female
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Dates
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Enumeration Date | 07/04/2023
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2606 CENTENNIAL PL
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City | TALLAHASSEE
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State | FL
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Zip | 32308-0572
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Country | US
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Telephone | 850-205-0189
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Fax |
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Provider Business Mailing Address
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Address Line | 10140 DEER RUN FRM RD
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City | FORT MYERS
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State | FL
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Zip | 33966-1045
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Country | US
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Telephone | 239-275-4242
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11021855
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License Number State | FL
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