NAFISA SADE OUTLAW NPI 1760127773

NPI Information

NPI: 1760127773
Provider Name: NAFISA SADE OUTLAW
Classification: Military Health Care Provider - 171000000X
Entity Type: Individual
Address:
5804 N MARSHALL ST
PHILADELPHIA, PA
ZIP 19120
Phone: (268) 368-3955
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Nafisa Sade Outlaw is a military health care provider in Philadelphia, PA. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Nafisa Sade Outlaw NPI is 1760127773. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5804 N MARSHALL ST
PHILADELPHIA, PA
ZIP 19120-315
Phone: (268) 368-3955

The enumeration date for this NPI number is 5/3/2022 and was last updated on 5/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171000000X	Military Health Care Provider		739258	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	822689610	MEDICAID	PENNSYLVANIA
2	0813	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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