Provider Demographics
NPI:1497303515
Name:KERR, AMBER NICOLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:KERR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11172 CAMPFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3904
Mailing Address - Country:US
Mailing Address - Phone:678-360-1513
Mailing Address - Fax:
Practice Address - Street 1:14286 BEACH BLVD STE 19-222
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-1561
Practice Address - Country:US
Practice Address - Phone:904-450-5061
Practice Address - Fax:866-730-7983
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8725802251P0200X
390200000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program