MEDICARE: ANNA ACKERMAN APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	3008985	KY

General Provider Information

NPI Number	:	1013312644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ACKERMAN APN

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	601 SOUTH FLOYD STREET
Second Line	:	SUITE 300
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1837
Country	:	US
Telephone Number	:	502-629-1515
Fax Number	:	502-629-1545

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	03/24/2025

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