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NPI Code Detail

MEDICARE: LUULA ABDULAHI JEYLANI NP

MEDICARE: LUULA ABDULAHI JEYLANI NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363LF0000XFamily Nurse Practitioner1171041TX

General Provider Information

NPI Number : 1104699511
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUULA ABDULAHI JEYLANI NP
Provider Business Mailing Address
First Line : PO BOX 746079
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6079
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 11251 FONDREN RD
Second Line :
City : HOUSTON
State : TX
Zip : 77096-5507
Country : US
Telephone Number : 281-836-0445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2023
Last Update Date : 02/11/2025

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