Provider Demographics
NPI:1497497713
Name:DONOVAN, KERRI-ANN (RN-BSN)
Entity Type:Individual
Prefix:
First Name:KERRI-ANN
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EXECUTIVE DR UNIT 112
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-0014
Mailing Address - Country:US
Mailing Address - Phone:978-766-2356
Mailing Address - Fax:
Practice Address - Street 1:15 EXECUTIVE DR UNIT 112
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-0014
Practice Address - Country:US
Practice Address - Phone:978-766-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2334374163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health