Provider Demographics
NPI:1164475315
Name:COLE, KERRY L BAYER (NP)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:L BAYER
Last Name:COLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 SOMERSET BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4998
Mailing Address - Country:US
Mailing Address - Phone:304-728-8661
Mailing Address - Fax:304-728-8518
Practice Address - Street 1:710 SOMERSET BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4998
Practice Address - Country:US
Practice Address - Phone:304-728-8661
Practice Address - Fax:304-728-8518
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV54825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily