Provider Demographics
NPI:1538332556
Name:KERNS, PAULA SUE (PT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:SUE
Last Name:KERNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 TERMINAL WAY
Mailing Address - Street 2:C-2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3430
Mailing Address - Country:US
Mailing Address - Phone:775-336-1256
Mailing Address - Fax:775-336-6410
Practice Address - Street 1:1475 TERMINAL WAY
Practice Address - Street 2:C-2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3430
Practice Address - Country:US
Practice Address - Phone:775-336-1256
Practice Address - Fax:775-336-6410
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist