Provider Demographics
NPI:1558008755
Name:KERR, ASHLEY MARIE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:KERR
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:MATTERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:247 WILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-1947
Mailing Address - Country:US
Mailing Address - Phone:330-610-8977
Mailing Address - Fax:
Practice Address - Street 1:247 WILBERT AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-610-8977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401052090310376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1558008755Medicaid