Peter Joseph Ackerman, RN
Individual provider Active NPI General Practice Registered Nurse · Duluth, MN
NPI 1124183892 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124183892
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Registered Nurse 163WG0000X
- License
- R 114481-3 (MN)
- Practice address
- 4209 Jay St
Duluth, MN 55804-1455 - Phone
- (218) 525-1920
- NPI assigned
- Dec 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 114481-3 | MN | MD | General Practice Registered Nurse |
| 153695-030 | WI | MD | General Practice Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | R 114481-3 | MN | Yes |
| General Practice Registered Nurse | 163WG0000X | WI |
Addresses
Primary practice location
4209 Jay St
Duluth, MN 55804-1455
Mailing address
4209 Jay St
Duluth, MN 55804-1455
Phone (218) 525-1920
Other providers in Duluth, MN
- Access Music Therapy, LLC
- Access North Center for Independent Living
- Accurate Home Care, LLC
- Alissa Dawn Acker
- Ann Martha Ackerman
- Jessica Acuna
- Debra L Adams-Koltes
- Jane Goldfarb Adams
- Jeffrey Lyndon Adams
- Katelyn Marie Adams
All providers in Duluth, MN · General Practice Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.