Provider Demographics
NPI:1043105232
Name:ACKER, KIMBERLY KRISTY (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KRISTY
Last Name:ACKER
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 1:602 5TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-1719
Mailing Address - Country:US
Mailing Address - Phone:218-340-2071
Mailing Address - Fax:
Practice Address - Street 1:602 5TH ST SW
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-1719
Practice Address - Country:US
Practice Address - Phone:218-340-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2457178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse