Provider Demographics
NPI:1538318290
Name:ECKERLE, AUDREY MARIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:MARIE
Last Name:ECKERLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1804
Mailing Address - Country:US
Mailing Address - Phone:859-236-6300
Mailing Address - Fax:859-236-6308
Practice Address - Street 1:204 S 2ND ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1804
Practice Address - Country:US
Practice Address - Phone:859-236-6300
Practice Address - Fax:859-236-6308
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5696P363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care