Provider Demographics
NPI:1497104046
Name:ACKER, CHERIE
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:ACKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1530
Mailing Address - Country:US
Mailing Address - Phone:810-210-3537
Mailing Address - Fax:
Practice Address - Street 1:621 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1530
Practice Address - Country:US
Practice Address - Phone:810-210-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIA260115092361247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other