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General NPI Number Information
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NPI Number | 1558398693
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Entity Type | Individual
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Provider Name | SHEKITTA LAVETT ACKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 986 MANSON/AXTELL RD.
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City | MANSON
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State | NC
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Zip | 27553
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Country | US
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Telephone | 252-456-2181
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Fax | 252-456-4875
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Provider Business Mailing Address
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Address Line | 1340 BOYLSTON ST
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City | BOSTON
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State | MA
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Zip | 02215-4302
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Country | US
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Telephone | 252-456-2181
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Fax | 252-456-4875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-00289
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License Number State | NC
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