Provider Demographics
NPI:1619617875
Name:AKPABIO, WIDI (NP)
Entity Type:Individual
Prefix:
First Name:WIDI
Middle Name:
Last Name:AKPABIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 GENESIS DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8651
Mailing Address - Country:US
Mailing Address - Phone:817-703-6257
Mailing Address - Fax:
Practice Address - Street 1:3125 MATLOCK RD STE 107
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2905
Practice Address - Country:US
Practice Address - Phone:817-899-8109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060033363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care