Provider Demographics
NPI:1124212659
Name:KERRO, MARGARET RUTH (PHN)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:RUTH
Last Name:KERRO
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1489
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-1489
Mailing Address - Country:US
Mailing Address - Phone:805-781-1744
Mailing Address - Fax:
Practice Address - Street 1:723 WALNUT DR
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2315
Practice Address - Country:US
Practice Address - Phone:805-237-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01295163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health