Provider Demographics
NPI:1265033393
Name:URHAHN, KERRI
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:URHAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63769-5428
Mailing Address - Country:US
Mailing Address - Phone:573-579-8172
Mailing Address - Fax:
Practice Address - Street 1:1750 S PERRYVILLE BLVD
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-6156
Practice Address - Country:US
Practice Address - Phone:573-547-2571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist