Provider Demographics
NPI:1992951479
Name:NANNETTE KAY ACRA, P.T.,PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NANNETTE KAY ACRA, P.T.,PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ACRA
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN PT
Authorized Official - Phone:260-494-5957
Mailing Address - Street 1:17718 N STATE ROAD 1
Mailing Address - Street 2:
Mailing Address - City:SPENCERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46788-9623
Mailing Address - Country:US
Mailing Address - Phone:260-494-5957
Mailing Address - Fax:260-238-4992
Practice Address - Street 1:17718 N STATE ROAD 1
Practice Address - Street 2:
Practice Address - City:SPENCERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46788-9623
Practice Address - Country:US
Practice Address - Phone:260-494-5957
Practice Address - Fax:260-238-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN53000114A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency