Healthcare Provider Details

I. General information

NPI: 1518551464
Provider Name (Legal Business Name): MARY ELIZABETH AKERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BLACK GOLD BLVD STE 212
HAZARD KY
41701-2620
US

IV. Provider business mailing address

210 BLACK GOLD BLVD STE 212
HAZARD KY
41701-2620
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-8178
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015732
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: