Provider Demographics
NPI:1528841665
Name:AKPAKA, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
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 1:675 TOWN SQUARE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2991
Mailing Address - Country:US
Mailing Address - Phone:945-296-9012
Mailing Address - Fax:
Practice Address - Street 1:675 TOWN SQUARE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2991
Practice Address - Country:US
Practice Address - Phone:945-296-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM72788363LP0808X
TX1106383363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health