Provider Demographics
NPI:1578983268
Name:KRASNOW, KERRI (MS, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:KRASNOW
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 LOGAN PL
Mailing Address - Street 2:APT 12
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3326
Mailing Address - Country:US
Mailing Address - Phone:757-602-5135
Mailing Address - Fax:
Practice Address - Street 1:563 LOGAN PL
Practice Address - Street 2:APT 12
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3326
Practice Address - Country:US
Practice Address - Phone:757-602-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260016202255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer