Provider Demographics
NPI:1467998393
Name:AKPUNKU, ANITA C (PA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:C
Last Name:AKPUNKU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N INTERSTATE 35 STE 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-5144
Mailing Address - Country:US
Mailing Address - Phone:940-323-3400
Mailing Address - Fax:940-323-3410
Practice Address - Street 1:2900 N INTERSTATE 35 STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5144
Practice Address - Country:US
Practice Address - Phone:940-323-3400
Practice Address - Fax:940-323-3410
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical