Provider Demographics
NPI:1598462939
Name:AKONJI, FIDELITY AGEH (NP)
Entity Type:Individual
Prefix:
First Name:FIDELITY
Middle Name:AGEH
Last Name:AKONJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:FIDELITY
Other - Middle Name:
Other - Last Name:AKONJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 306417
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6417
Mailing Address - Country:US
Mailing Address - Phone:931-253-1110
Mailing Address - Fax:931-722-9919
Practice Address - Street 1:1778 E. STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1846
Practice Address - Country:US
Practice Address - Phone:463-235-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71073550A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner