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General NPI Number Information
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NPI Number | 1871196014
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Entity Type | Individual
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Provider Name | AZRA ABBASI AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 2205 JOLLY RD STE B
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City | OKEMOS
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State | MI
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Zip | 48864-3983
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Country | US
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Telephone | 517-347-4085
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40412
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 248-824-6500
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Fax | 855-618-6655
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704287117
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4704287117
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License Number State | MI
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