Healthcare Provider Details

I. General information

NPI: 1922032861
Provider Name (Legal Business Name): KIMBERLY L. ACKERMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 10TH AVE N
BILLINGS MT
59101-0703
US

IV. Provider business mailing address

4988 STONE RIDGE CIR
BILLINGS MT
59106-4418
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-4000
  • Fax:
Mailing address:
  • Phone: 406-534-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN26870
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNUR-APRN-LIC-100462
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-100462
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNUR-APRN-LIC-100504
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: