Basic Information
Provider Information
NPI: 1639208515
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKINS
FirstName: CORTNEY
MiddleName: K
NamePrefix: MRS.
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 99371
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761990371
CountryCode: US
TelephoneNumber: 6828851855
FaxNumber: 6828857347
Practice Location
Address1: 801 7TH AVE
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761042733
CountryCode: US
TelephoneNumber: 6828851475
FaxNumber: 6828857520
Other Information
ProviderEnumerationDate: 03/05/2007
LastUpdateDate: 04/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA04741TXY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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