Provider Demographics
NPI:1457301830
Name:ACKERMAN, LORRAINE (FNP)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-322-4542
Mailing Address - Fax:
Practice Address - Street 1:407 A ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MT
Practice Address - Zip Code:59019-7600
Practice Address - Country:US
Practice Address - Phone:406-322-4542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4301180OtherMT MDCD PIN
MT000373550OtherMT BCBS PIN
MTR12259Medicare UPIN
MT000085492Medicare PIN
MT000373550OtherMT BCBS PIN
MTP00013861Medicare PIN
MT1153260008Medicare PIN
MT4301180OtherMT MDCD PIN