Provider Demographics
NPI:1073378709
Name:ECKROAT, KERRI ZEHRUNG
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:ZEHRUNG
Last Name:ECKROAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15916 SKY RUN DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8425
Mailing Address - Country:US
Mailing Address - Phone:918-284-6212
Mailing Address - Fax:
Practice Address - Street 1:15916 SKY RUN DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8425
Practice Address - Country:US
Practice Address - Phone:918-284-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0082344163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management