Provider Demographics
NPI:1164712709
Name:STRINGFELLOW, KERRY RODGERICK (RN)
Entity Type:Individual
Prefix:MR
First Name:KERRY
Middle Name:RODGERICK
Last Name:STRINGFELLOW
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 VICKERS DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1605
Mailing Address - Country:US
Mailing Address - Phone:818-248-7086
Mailing Address - Fax:818-441-5353
Practice Address - Street 1:3385 VICKERS DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1605
Practice Address - Country:US
Practice Address - Phone:818-248-7086
Practice Address - Fax:818-441-5353
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA401486163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse