=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457026395
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAKIM NURU PMHNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2021
-----------------------------------------------------
Last Update Date | 03/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 388 S MAIN ST STE 440
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44311-4407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-353-8336
-----------------------------------------------------
Fax | 234-274-8272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 388 S MAIN ST STE 440
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44311-4407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-353-8336
-----------------------------------------------------
Fax | 234-274-8272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN.453845
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0030423
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------