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Individual

LAURA ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
250 CHERRY ST SE, GRAND RAPIDS, MI 49503-4608
(616) 685-5600
(616) 685-6745
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704235109
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200338221
TRICARE
MI
05
4823034
MI
01
5008705720
BCBSM
MA
Enumeration date
06/28/2006
Last updated
11/23/2016
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