Provider Demographics
NPI:1821067182
Name:KERN, ELIZABETH MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:KERN
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:2817 REILLY ROAD MCXC-COD CREDENTIALS
Mailing Address - Street 2:WOMACK ARMY MEDICAL CENTER
Mailing Address - City:FT. BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:910-907-8922
Mailing Address - Fax:910-907-6060
Practice Address - Street 1:2817 REILLY ROAD MCXC-COD CREDENTIALS
Practice Address - Street 2:WOMACK ARMY MEDICAL CENTER
Practice Address - City:FT. BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-6060
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC103705363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant