Provider Demographics
NPI:1275138612
Name:AKERS, MIRANDA (FNP)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:AKERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2459
Mailing Address - Country:US
Mailing Address - Phone:816-364-1507
Mailing Address - Fax:
Practice Address - Street 1:2617 BURRIS RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-3607
Practice Address - Country:US
Practice Address - Phone:660-562-7546
Practice Address - Fax:660-562-2266
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA176885363LF0000X
MO2020032641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily