Individual
HOLLY ACKERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
120 BOYD ST, DE SOTO, MO 63020-1702
(636) 282-0380
Mailing address
5000 CEDAR PLAZA PKWY STE 300, SAINT LOUIS, MO 63128-3891
(636) 282-0380
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
2018010406
MO
363L00000X
Nurse Practitioner
2018010406
MO
363LF0000X
Family Nurse Practitioner
Primary
2018010406
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018010406
MO STATE LICENSE
MO
Enumeration date
04/22/2018
Last updated
02/12/2026
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