MEDICARE: LORRAINE ACKERMAN FNP

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	363LF0000X	Family Nurse Practitioner	11203	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4301180	OTHER	MT	MT MDCD PIN
2	000373550	OTHER	MT	MT BCBS PIN

General Provider Information

NPI Number	:	1457301830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAINE ACKERMAN FNP

Provider Business Mailing Address
First Line	:	PO BOX 35100
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59107-5100
Country	:	US
Telephone Number	:	406-322-4542
Fax Number	:

Provider Business Practice Location Address
First Line	:	407 A ST
Second Line	:
City	:	COLUMBUS
State	:	MT
Zip	:	59019-7600
Country	:	US
Telephone Number	:	406-322-4542
Fax Number	:

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	04/30/2013

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