Kelly Elaine Ackerman, CMT
Individual provider Active NPI Massage Therapist · Saint Cloud, MN
NPI 1437627353 · NPPES record last updated Nov 8, 2018
Key facts
- NPI
- 1437627353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- Practice address
- 203 Cooper Ave N Ste 160
Saint Cloud, MN 56303-4418 - Phone
- (320) 309-7284
- NPI assigned
- Nov 8, 2018
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MN | Yes |
Addresses
Primary practice location
203 Cooper Ave N Ste 160
Saint Cloud, MN 56303-4418
Mailing address
203 Cooper Ave N Ste 160
Saint Cloud, MN 56303-4418
Phone (320) 309-7284
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-1889495 | Medicaid | MN |
Other providers in Saint Cloud, MN
- Accurate Hearing Services Inc
- Achieved Goals, LLC
- Angela Rose Ackerman
- Cassandra Lee Ackerman
- Joshua Robert Ackerman
- Acquire Health Center LLC
- Angela Adamek
- Carolyn Adams
- Kelly Adams
- Fadumo Adan
All providers in Saint Cloud, MN · Massage Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2018. 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.