Provider Demographics
NPI:1124635586
Name:MAIMAI, LUBABATU INUWA
Entity type:Individual
Prefix:
First Name:LUBABATU
Middle Name:INUWA
Last Name:MAIMAI
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 1:330 JAKE ALEXANDER BLVD W STE 103
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-1385
Mailing Address - Country:US
Mailing Address - Phone:704-519-2366
Mailing Address - Fax:844-269-8197
Practice Address - Street 1:330 JAKE ALEXANDER BLVD W STE 103
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1385
Practice Address - Country:US
Practice Address - Phone:704-519-2366
Practice Address - Fax:844-269-8197
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily