Provider Demographics
NPI:1508225368
Name:KERR, MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:RAMSDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:2203 NW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66618-3275
Mailing Address - Country:US
Mailing Address - Phone:785-220-2059
Mailing Address - Fax:
Practice Address - Street 1:801 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2338
Practice Address - Country:US
Practice Address - Phone:785-220-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01707225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant