Provider Demographics
NPI:1154863553
Name:DAVID, AKILAH (FNP)
Entity Type:Individual
Prefix:
First Name:AKILAH
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NOSTRAND AVE
Mailing Address - Street 2:3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2201
Mailing Address - Country:US
Mailing Address - Phone:646-643-0982
Mailing Address - Fax:
Practice Address - Street 1:1309 NOSTRAND AVE
Practice Address - Street 2:3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2201
Practice Address - Country:US
Practice Address - Phone:646-643-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY560529163W00000X
NY339076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse