Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP30004232 | WA |
NPI | 1023004256 |
---|---|
Provider Name | Christine A Acker |
First Address | Kennewick, WA 99336-6709 |
Second Address | Kennewick, WA 99336-6709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 27/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S49228 | (02) |