Provider Demographics
NPI:1790995652
Name:HERNING, KERI RENEE (MS OTR)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:RENEE
Last Name:HERNING
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:RENEE
Other - Last Name:NASLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 BARNETTE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4502
Mailing Address - Country:US
Mailing Address - Phone:907-456-4003
Mailing Address - Fax:
Practice Address - Street 1:1020 BARNETTE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4502
Practice Address - Country:US
Practice Address - Phone:907-456-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1661174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist