Provider Demographics
NPI:1710427919
Name:ANDERSON, KERRI M (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WILLIAM H JOHNSON ST STE 150
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2772
Mailing Address - Country:US
Mailing Address - Phone:843-777-5146
Mailing Address - Fax:843-777-5296
Practice Address - Street 1:101 WILLIAM H JOHNSON ST STE 150
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2772
Practice Address - Country:US
Practice Address - Phone:843-777-5146
Practice Address - Fax:843-777-5159
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily