Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN 129235 | TX |
NPI | 1003280686 |
---|---|
Provider Name | Susan Akberzie |
First Address | North Richland Hills, TX 76182-7539 |
Second Address | Fort Worth, TX 76177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2015 |
Last Update Date | 16/05/2018 |