Provider Demographics
NPI:1861827669
Name:AKWUBA, LILIAN IFEOMA (DNP)
Entity Type:Individual
Prefix:DR
First Name:LILIAN
Middle Name:IFEOMA
Last Name:AKWUBA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:128 MITYLENE PARK LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3758
Mailing Address - Country:US
Mailing Address - Phone:334-538-2769
Mailing Address - Fax:334-239-7062
Practice Address - Street 1:128 MITYLENE PARK LN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3758
Practice Address - Country:US
Practice Address - Phone:334-239-7020
Practice Address - Fax:334-239-7062
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-103472363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health