Provider Demographics
NPI:1033273875
Name:KERR, LINDA JEAN (RN, NP-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:KERR
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10611 LANTERN BAY CV
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-2126
Mailing Address - Country:US
Mailing Address - Phone:260-637-2982
Mailing Address - Fax:
Practice Address - Street 1:10611 LANTERN BAY CV
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-2126
Practice Address - Country:US
Practice Address - Phone:260-637-2982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28089243A163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health