Provider Demographics
NPI:1629717160
Name:KERR, JESSICA HENSLEY
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:HENSLEY
Last Name:KERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 COUNTY ROAD 258
Mailing Address - Street 2:
Mailing Address - City:SANTA ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:76878-6006
Mailing Address - Country:US
Mailing Address - Phone:806-392-4344
Mailing Address - Fax:
Practice Address - Street 1:105 N 2ND ST
Practice Address - Street 2:
Practice Address - City:SANTA ANNA
Practice Address - State:TX
Practice Address - Zip Code:76878-2039
Practice Address - Country:US
Practice Address - Phone:325-348-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1085409363LF0000X
AL3-000933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily