Provider Demographics
NPI:1093133142
Name:FLECKENSTEIN, KERRY
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:FLECKENSTEIN
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 1:801 NORTHPOINT PKWY # V-139
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1973
Mailing Address - Country:US
Mailing Address - Phone:561-899-0999
Mailing Address - Fax:
Practice Address - Street 1:801 NORTHPOINT PKWY # V-139
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1973
Practice Address - Country:US
Practice Address - Phone:561-899-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide