MEDICARE: VIRGINIA ACKER

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	101YP2500X	Professional Counselor	933	KS

General Provider Information

NPI Number	:	1396420253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA ACKER

Provider Business Mailing Address
First Line	:	430 TYLER ST
Second Line	:
City	:	POMONA
State	:	KS
Zip	:	66076-8104
Country	:	US
Telephone Number	:	785-253-7294
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 TYLER ST
Second Line	:
City	:	POMONA
State	:	KS
Zip	:	66076-8104
Country	:	US
Telephone Number	:	785-253-7294
Fax Number	:

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

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	06/19/2023

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Directions to “ VIRGINIA ACKER ” Practice Location

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