Healthcare Provider Details

I. General information

NPI: 1255277158
Provider Name (Legal Business Name): CHEANDRI ACKERMANN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 LIBERTY VIEW LN
LYNCHBURG VA
24502-2291
US

IV. Provider business mailing address

1840 BEAUTY WAY
VIRGINIA BEACH VA
23456-6942
US

V. Phone/Fax

Practice location:
  • Phone: 434-592-7444
  • Fax:
Mailing address:
  • Phone: 757-412-9048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: