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General NPI Number Information
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NPI Number | 1437680287
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Entity Type | Organization
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Legal Business Name | KATELYN ACKERMAN
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 298 INDUSTRIAL RD
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City | WALTERBORO
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State | SC
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Zip | 29488-8273
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Country | US
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Telephone | 843-538-3344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830
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City | WALTERBORO
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State | SC
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Zip | 29488-0009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KATELYN LEIGH ACKERMAN
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Credential |
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Telephone | 843-538-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHCP-0679
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License Number State | SC
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