Healthcare Provider Details

I. General information

NPI: 1285366112
Provider Name (Legal Business Name): EMILY KATE ACKLEY AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PARKWAY OFFICE CT STE 100
CARY NC
27518-7431
US

IV. Provider business mailing address

115 PARKWAY OFFICE CT STE 100
CARY NC
27518-7431
US

V. Phone/Fax

Practice location:
  • Phone: 919-851-3800
  • Fax: 919-851-3803
Mailing address:
  • Phone: 919-851-3800
  • Fax: 919-851-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number30002422
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4237
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: