Provider Demographics
NPI:1700236619
Name:SEM, KEARA
Entity Type:Individual
Prefix:
First Name:KEARA
Middle Name:
Last Name:SEM
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 1:36 LISA LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-3231
Mailing Address - Country:US
Mailing Address - Phone:978-771-8782
Mailing Address - Fax:
Practice Address - Street 1:36 LISA LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-3231
Practice Address - Country:US
Practice Address - Phone:978-771-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program