Provider Demographics
NPI:1053891507
Name:ACKERMAN, CATRICE LASHAY (ARNP)
Entity type:Individual
Prefix:
First Name:CATRICE
Middle Name:LASHAY
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-933-9600
Mailing Address - Fax:954-781-9828
Practice Address - Street 1:3896 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6612
Practice Address - Country:US
Practice Address - Phone:954-933-9600
Practice Address - Fax:954-781-9828
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9278604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily