Basic Information
Provider Information
NPI: 1003142514
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKERS
FirstName: AIMEE
MiddleName: OLIVIA
NamePrefix: MS.
NameSuffix:  
Credential: CPM, LM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FAIRMAN
OtherFirstName: AIMEE
OtherMiddleName: OLIVIA
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: CPM, LM
OtherLastNameType: 1
Mailing Information
Address1: 400 VIRGINIA AVE
Address2:  
City: FRONT ROYAL
State: VA
PostalCode: 226302628
CountryCode: US
TelephoneNumber: 5406602459
FaxNumber:  
Practice Location
Address1: 400 VIRGINIA AVE
Address2:  
City: FRONT ROYAL
State: VA
PostalCode: 22630
CountryCode: US
TelephoneNumber: 5406602459
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/19/2009
LastUpdateDate: 06/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
176B00000X0129000046VAY Other Service ProvidersMidwife 

No ID Information.


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