Provider Demographics
NPI:1821024688
Name:KEBERLEIN-LYNN, KERRI LYNN (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:LYNN
Last Name:KEBERLEIN-LYNN
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:6420 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119
Practice Address - Country:US
Practice Address - Phone:913-945-9700
Practice Address - Fax:913-945-9707
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44287363L00000X
MO154978363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
500026194OtherRR MEDICARE
610311OtherFIRSTGUARD KUMW UC
KS100250480FMedicaid
R32092Medicare UPIN
KS100250480FMedicaid
KSJ61B641AMedicare PIN