Provider Demographics
NPI:1558975433
Name:KERR AREA RURAL MEDICAL ALLIANCE PLLC
Entity Type:Organization
Organization Name:KERR AREA RURAL MEDICAL ALLIANCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:252-598-1059
Mailing Address - Street 1:PO BOX 1757
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-1757
Mailing Address - Country:US
Mailing Address - Phone:252-598-1059
Mailing Address - Fax:
Practice Address - Street 1:425B S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4201
Practice Address - Country:US
Practice Address - Phone:252-598-1059
Practice Address - Fax:252-598-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty