Provider Demographics
NPI:1629380670
Name:ACKMAN, JAMIE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:ACKMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MARIE
Other - Last Name:MEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2205 S HOFSTAD AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4781
Mailing Address - Country:US
Mailing Address - Phone:712-490-4086
Mailing Address - Fax:
Practice Address - Street 1:1201 S GRANGE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-328-7690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist