Tina Joy Ackerson, RN
Individual provider Active NPI Registered Nurse · Lake Stevens, WA
NPI 1265948673 · NPPES record last updated Dec 20, 2017
Key facts
- NPI
- 1265948673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN60201096 (WA)
- Practice address
- 8213 23Rd PL NE
Lake Stevens, WA 98258-6419 - Phone
- (360) 610-5864
- NPI assigned
- Dec 20, 2017
- Sex
- Female
- 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 |
|---|---|---|---|
| RN60201096 | WA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60201096 | WA | Yes |
Addresses
Primary practice location
8213 23Rd PL NE
Lake Stevens, WA 98258-6419
Mailing address
8213 23Rd PL NE
Lake Stevens, WA 98258-6419
Phone (360) 610-5864
Other names
- Tina Joy Brown
Other providers in Lake Stevens, WA
- 1918 Winter Street Operating Co LLC
- Aafc Enterprises LLC
- Mackenzie Claire Acker
- Brandon Scott Adams
- Michaela Adams
- Aj Family Dentistry
- Alderwood Ankle & Foot Clinic P.S.
- Amy Allyn
All providers in Lake Stevens, WA · Registered Nurse in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2017. 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.