MEDICARE: JENNA RAE 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	1041C0700X	Clinical Social Worker	12726-123	WI

General Provider Information

NPI Number	:	1437860855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA RAE ACKER

Provider Business Mailing Address
First Line	:	1382 WINCHESTER PASS
Second Line	:
City	:	VERONA
State	:	WI
Zip	:	53593-2288
Country	:	US
Telephone Number	:	608-438-8925
Fax Number	:

Provider Business Practice Location Address
First Line	:	1382 WINCHESTER PASS
Second Line	:
City	:	VERONA
State	:	WI
Zip	:	53593-2288
Country	:	US
Telephone Number	:	608-438-8925
Fax Number	:

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

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/28/2025

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