Provider Demographics
NPI:1699228957
Name:AKARI, EDNA IMA
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:IMA
Last Name:AKARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7036 W THURSTON CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2269
Mailing Address - Country:US
Mailing Address - Phone:414-527-4127
Mailing Address - Fax:
Practice Address - Street 1:7036 W THURSTON CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2269
Practice Address - Country:US
Practice Address - Phone:414-527-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI307310-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse