Provider Demographics
NPI:1558504993
Name:ACKLEY, GERRI LYNN (RN)
Entity Type:Individual
Prefix:
First Name:GERRI
Middle Name:LYNN
Last Name:ACKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 CARY ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-1705
Mailing Address - Country:US
Mailing Address - Phone:307-254-1491
Mailing Address - Fax:
Practice Address - Street 1:672 CARY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-1705
Practice Address - Country:US
Practice Address - Phone:307-254-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY22838163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse