Provider Demographics
NPI:1033961073
Name:KERR, STACY (RN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8990 KIRBY DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2853
Mailing Address - Country:US
Mailing Address - Phone:832-771-0433
Mailing Address - Fax:
Practice Address - Street 1:1934 ACACIAWOOD WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-0006
Practice Address - Country:US
Practice Address - Phone:832-771-0433
Practice Address - Fax:855-228-7878
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643210171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator