Provider Demographics
NPI:1528206364
Name:ACKER, SHAUNA T (DNP, CNM, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:T
Last Name:ACKER
Suffix:
Gender:F
Credentials:DNP, CNM, FNP-C
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:T
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CNM
Mailing Address - Street 1:7562 BIGTOOTH MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9483
Mailing Address - Country:US
Mailing Address - Phone:970-765-5075
Mailing Address - Fax:
Practice Address - Street 1:7562 BIGTOOTH MAPLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80925-9483
Practice Address - Country:US
Practice Address - Phone:970-765-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992843-NP363LF0000X
MO155634367A00000X
COAPN.0013001-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
846002707056OtherROCKY MTN HEALTH PLANS
CO44683065Medicaid
MJ2143105OtherDEA
MJ2143105OtherDEA