Provider Demographics
NPI:1235143330
Name:KERNS, PAMELA (APRN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:KERNS
Suffix:
Gender:F
Credentials:APRN
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 256
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67402-0256
Mailing Address - Country:US
Mailing Address - Phone:785-823-0633
Mailing Address - Fax:785-823-0685
Practice Address - Street 1:730 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8778
Practice Address - Country:US
Practice Address - Phone:316-283-1141
Practice Address - Fax:316-283-1162
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45365363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100430400IMedicaid
KSKA2069005Medicare PIN
KS016701017Medicare PIN
KS100430400IMedicaid