Provider Demographics
NPI:1790099463
Name:KERR, KARLENE H (RN)
Entity Type:Individual
Prefix:
First Name:KARLENE
Middle Name:H
Last Name:KERR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1013
Mailing Address - Country:US
Mailing Address - Phone:845-615-1335
Mailing Address - Fax:845-360-5112
Practice Address - Street 1:48 GREGORY DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1013
Practice Address - Country:US
Practice Address - Phone:845-615-1335
Practice Address - Fax:845-360-5112
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY581688-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool