Provider Demographics
NPI:1558398693
Name:ACKER, SHEKITTA LAVETT (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHEKITTA
Middle Name:LAVETT
Last Name:ACKER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1340 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4302
Mailing Address - Country:US
Mailing Address - Phone:252-456-2181
Mailing Address - Fax:252-456-4875
Practice Address - Street 1:986 MANSON/AXTELL RD.
Practice Address - Street 2:
Practice Address - City:MANSON
Practice Address - State:NC
Practice Address - Zip Code:27553
Practice Address - Country:US
Practice Address - Phone:252-456-2181
Practice Address - Fax:252-456-4875
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2017-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-00289363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical