Provider Demographics
NPI:1245847342
Name:BAKKAL, NUHA (FNP-C)
Entity type:Individual
Prefix:
First Name:NUHA
Middle Name:
Last Name:BAKKAL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30516 DEPT 1114
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909
Mailing Address - Country:US
Mailing Address - Phone:248-893-3220
Mailing Address - Fax:248-893-2951
Practice Address - Street 1:28455 HAGGERTY RD STE 200
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2982
Practice Address - Country:US
Practice Address - Phone:248-893-3200
Practice Address - Fax:248-893-2950
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704319006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily