Provider Demographics
NPI:1467841916
Name:MEARS, KERRILYNN
Entity Type:Individual
Prefix:
First Name:KERRILYNN
Middle Name:
Last Name:MEARS
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 1:559 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-4257
Mailing Address - Country:US
Mailing Address - Phone:914-799-1982
Mailing Address - Fax:
Practice Address - Street 1:559 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-4257
Practice Address - Country:US
Practice Address - Phone:914-799-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562169-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse