Provider Demographics
NPI:1396217568
Name:AWUOR, KERINA P (NP)
Entity Type:Individual
Prefix:
First Name:KERINA
Middle Name:P
Last Name:AWUOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AWUOR
Other - Middle Name:P
Other - Last Name:KERINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:656 PARK COMMONS CT APT K
Mailing Address - Street 2:
Mailing Address - City:VALLEY PARK
Mailing Address - State:MO
Mailing Address - Zip Code:63088-1483
Mailing Address - Country:US
Mailing Address - Phone:314-255-8247
Mailing Address - Fax:
Practice Address - Street 1:656 PARK COMMONS CT APT K
Practice Address - Street 2:
Practice Address - City:VALLEY PARK
Practice Address - State:MO
Practice Address - Zip Code:63088-1483
Practice Address - Country:US
Practice Address - Phone:314-255-8247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018033940363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner