Provider Demographics
NPI:1942971759
Name:AKPAKA, PEARL AUGUSTA
Entity Type:Individual
Prefix:
First Name:PEARL
Middle Name:AUGUSTA
Last Name:AKPAKA
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 1:4078 ROTTERDAM PASS
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6077
Mailing Address - Country:US
Mailing Address - Phone:678-860-3920
Mailing Address - Fax:
Practice Address - Street 1:4078 ROTTERDAM PASS
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-6077
Practice Address - Country:US
Practice Address - Phone:678-860-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212785367500000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program