Provider Demographics
NPI:1225409477
Name:HULL, KERI LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:LYNN
Last Name:HULL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:KOGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941
Mailing Address - Country:US
Mailing Address - Phone:307-367-4133
Mailing Address - Fax:307-367-6636
Practice Address - Street 1:625 E HENNICK ST
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941
Practice Address - Country:US
Practice Address - Phone:307-367-4132
Practice Address - Fax:307-367-6636
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY36333.1435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily