MEDICARE: HANDS2HEARTS ACADEMY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202K00000X	Phlebology Physician

General Provider Information

NPI Number	:	1053279190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDS2HEARTS ACADEMY LLC

Provider Business Mailing Address
First Line	:	3934 DIXIE HWY STE 410B
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-4163
Country	:	US
Telephone Number	:	502-693-2187
Fax Number	:	502-333-0645

Provider Business Practice Location Address
First Line	:	3934 DIXIE HWY STE 410B
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-4163
Country	:	US
Telephone Number	:	502-693-2187
Fax Number	:	502-333-0645

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MYRA WILEY
Credential	:	RN
Telephone Number	:	502-693-2187

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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