MEDICARE: SIERRA KHADIJAH AKINWUMI 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
1	363LF0000X	Family Nurse Practitioner	71012402A	IN
2	363L00000X	Nurse Practitioner	71012402A	IN

General Provider Information

NPI Number	:	1922757384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA KHADIJAH AKINWUMI NP

Provider Business Mailing Address
First Line	:	PO BOX 749495
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9495
Country	:	US
Telephone Number	:	394-328-3312
Fax Number	:	813-321-1296

Provider Business Practice Location Address
First Line	:	1011 INDIANAPOLIS RD
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-1598
Country	:	US
Telephone Number	:	931-253-1110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	12/12/2024

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