Individual
FAKHRA AHMAD-BODLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
400 SUN TEMPLE DR, MADISON, AL 35758-5924
(256) 774-5524
(256) 774-5523
Mailing address
123 FOXHOUND DR, MADISON, AL 35758-6881
(626) 644-7723
(256) 774-5523
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-113025
AL
363LF0000X
Family Nurse Practitioner
14489
CA
363LF0000X
Family Nurse Practitioner
APN0000013314
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152756
—
AL
Enumeration date
03/01/2007
Last updated
10/07/2023
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