Provider Demographics
NPI:1982389938
Name:AKTER, SHORMIN (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHORMIN
Middle Name:
Last Name:AKTER
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30564 CEDARS DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2532
Mailing Address - Country:US
Mailing Address - Phone:313-320-5734
Mailing Address - Fax:
Practice Address - Street 1:24831 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-3390
Practice Address - Country:US
Practice Address - Phone:586-486-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704325804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily