Provider Demographics
NPI:1083360085
Name:COHLMEYER, KERRY E (RN)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:E
Last Name:COHLMEYER
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 1:300 ORRINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1625
Mailing Address - Country:US
Mailing Address - Phone:916-298-8862
Mailing Address - Fax:
Practice Address - Street 1:300 ORRINGTON CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-1625
Practice Address - Country:US
Practice Address - Phone:916-298-8862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363722163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse