Provider Demographics
NPI:1861257537
Name:HANNOUFA, FAHIMA (PA)
Entity type:Individual
Prefix:
First Name:FAHIMA
Middle Name:
Last Name:HANNOUFA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:208 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-6326
Mailing Address - Country:US
Mailing Address - Phone:304-336-5098
Mailing Address - Fax:304-306-8868
Practice Address - Street 1:208 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:WV
Practice Address - Zip Code:26074-1082
Practice Address - Country:US
Practice Address - Phone:304-336-5098
Practice Address - Fax:304-336-8868
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant