Provider Demographics
NPI:1245725159
Name:MANSFIELD, NAKESHA N (APRN)
Entity type:Individual
Prefix:
First Name:NAKESHA
Middle Name:N
Last Name:MANSFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NAKESHA
Other - Middle Name:N
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0325
Mailing Address - Fax:
Practice Address - Street 1:401 E CHESTNUT ST UNIT 370
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-562-6510
Practice Address - Fax:502-562-6515
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1103752163W00000X
KY3012532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse