Provider Demographics
NPI:1609559368
Name:MISGNA, AKBERET GIRMAY
Entity type:Individual
Prefix:
First Name:AKBERET
Middle Name:GIRMAY
Last Name:MISGNA
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 1:1225 LOWDEN CIR APT 130
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-6919
Mailing Address - Country:US
Mailing Address - Phone:970-324-7951
Mailing Address - Fax:
Practice Address - Street 1:1225 LOWDEN CIR APT 130
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-6919
Practice Address - Country:US
Practice Address - Phone:970-324-7951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44532309343900000X
347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)