Provider Demographics
NPI:1326266586
Name:KERR, CHARLOTTE ROSE (LAC, RN)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ROSE
Last Name:KERR
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 MONTPELIER RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6010
Mailing Address - Country:US
Mailing Address - Phone:410-888-9048
Mailing Address - Fax:410-888-9004
Practice Address - Street 1:7750 MONTPELIER RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-6010
Practice Address - Country:US
Practice Address - Phone:410-888-9048
Practice Address - Fax:410-888-9004
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR038983163W00000X
MDU00108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD416055-03OtherCAREFIRST NON-PAR NO.