Provider Demographics
NPI:1619448495
Name:ACKERMAN, BARBARA GAIL (APRN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:GAIL
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11516 HERBER CT
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-7413
Mailing Address - Country:US
Mailing Address - Phone:859-380-5961
Mailing Address - Fax:
Practice Address - Street 1:237 WILLIAM HOWARD TAFT RD FL 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2610
Practice Address - Country:US
Practice Address - Phone:513-263-8590
Practice Address - Fax:513-272-0362
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012611363LF0000X
OH023269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0337258Medicaid