Provider Demographics
NPI:1023004256
Name:ACKER, CHRISTINE A (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:ACKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 W GRANDRIDGE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6709
Mailing Address - Country:US
Mailing Address - Phone:509-735-2325
Mailing Address - Fax:509-735-3222
Practice Address - Street 1:7201 W GRANDRIDGE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6709
Practice Address - Country:US
Practice Address - Phone:509-735-2325
Practice Address - Fax:509-735-3222
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004232363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
S49228Medicare UPIN