Provider Demographics
NPI:1558402669
Name:KERNS, CAROLINE E (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:E
Last Name:KERNS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 SENEKER LN
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-3629
Mailing Address - Country:US
Mailing Address - Phone:423-323-4507
Mailing Address - Fax:
Practice Address - Street 1:154 BLOUNTVILLE BYPASS
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617
Practice Address - Country:US
Practice Address - Phone:423-279-2784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000032992164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse