Provider Demographics
NPI:1790328094
Name:KERR, JEANNE MARIE (MSN APRN NP-C)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:KERR
Suffix:
Gender:F
Credentials:MSN APRN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 BRYCE CT
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-7968
Mailing Address - Country:US
Mailing Address - Phone:812-306-6693
Mailing Address - Fax:
Practice Address - Street 1:1630 MASON AVE STE C
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4503
Practice Address - Country:US
Practice Address - Phone:386-238-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28220237A163W00000X
FL9556993163W00000X
INF09190634363LF0000X
FL11011720363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse