Provider Demographics
NPI:1013393503
Name:AKERS, ELAINE (RN)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:AKERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:WYATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:701 S MOUNT VERNON AVE
Mailing Address - Street 2:STUDENT HEALTH SERVICES
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410-2705
Mailing Address - Country:US
Mailing Address - Phone:909-384-4495
Mailing Address - Fax:909-888-6297
Practice Address - Street 1:701 S MOUNT VERNON AVE
Practice Address - Street 2:STUDENT HEALTH SERVICES
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-2705
Practice Address - Country:US
Practice Address - Phone:909-384-4495
Practice Address - Fax:909-888-6297
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280062163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health