Provider Demographics
NPI:1851411425
Name:AKERS, PAULA SMITH (FNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:SMITH
Last Name:AKERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:S
Other - Last Name:MCLARTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2888 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5347
Mailing Address - Country:US
Mailing Address - Phone:662-234-8286
Mailing Address - Fax:662-234-6644
Practice Address - Street 1:2888 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5347
Practice Address - Country:US
Practice Address - Phone:662-234-8286
Practice Address - Fax:662-234-6644
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR600091208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014633Medicaid