Provider Demographics
NPI:1659337095
Name:KERR, JANICE R (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:R
Last Name:KERR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-520-5476
Mailing Address - Fax:501-520-5486
Practice Address - Street 1:1662 HIGDON FERRY ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-520-5476
Practice Address - Fax:501-520-5486
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01722ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164879758Medicaid
P00227828Medicare PIN
P96451Medicare UPIN
5X488F484Medicare PIN
AR5X4887470Medicare PIN
AR164879758Medicaid