Provider Demographics
NPI:1699213595
Name:ERNST, KERI ELIZABETH ZUG (MSN)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:ELIZABETH ZUG
Last Name:ERNST
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2465 SHORELINE DR APT 301
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6218
Mailing Address - Country:US
Mailing Address - Phone:484-535-0379
Mailing Address - Fax:484-535-0379
Practice Address - Street 1:3451 E 12TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-3463
Practice Address - Country:US
Practice Address - Phone:510-535-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95005668363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health