Provider Demographics
NPI:1528557808
Name:AKIN, CARL III (RN, EMT-P)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:
Last Name:AKIN
Suffix:III
Gender:M
Credentials:RN, EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-2237
Mailing Address - Country:US
Mailing Address - Phone:502-664-9469
Mailing Address - Fax:
Practice Address - Street 1:1511 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-2237
Practice Address - Country:US
Practice Address - Phone:502-664-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1036811-1659146L00000X
KY1133799163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic