Provider Demographics
NPI:1508617846
Name:JAJA, ABUBAKAR
Entity Type:Individual
Prefix:
First Name:ABUBAKAR
Middle Name:
Last Name:JAJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 ABIGAIL LN
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8745
Mailing Address - Country:US
Mailing Address - Phone:151-549-4064
Mailing Address - Fax:
Practice Address - Street 1:230 ABIGAIL LANE, WAUKEE IA 50263
Practice Address - Street 2:
Practice Address - City:WAUKEE, IA, USA
Practice Address - State:IA
Practice Address - Zip Code:50263
Practice Address - Country:US
Practice Address - Phone:515-494-0649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty