Healthcare Provider Details

I. General information

NPI: 1619431772
Provider Name (Legal Business Name): SARAH M ACKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 N SENATE AVE STE 100
INDIANAPOLIS IN
46202-3297
US

IV. Provider business mailing address

6655 E SPRING LAKE RD
MOORESVILLE IN
46158-6205
US

V. Phone/Fax

Practice location:
  • Phone: 317-630-7382
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71009600A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28220308A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: