Provider Demographics
NPI:1821207150
Name:WHITEHEAD, KERRI ANNE (MSPT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:ANNE
Last Name:WHITEHEAD
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Gender:F
Credentials:MSPT, ATC
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Other - First Name:
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Mailing Address - Street 1:8614 E STATE ROAD 70
Mailing Address - Street 2:STE 200
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-3710
Mailing Address - Country:US
Mailing Address - Phone:941-727-1243
Mailing Address - Fax:941-751-9039
Practice Address - Street 1:8614 E STATE ROAD 70
Practice Address - Street 2:STE 200
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-3710
Practice Address - Country:US
Practice Address - Phone:941-727-1243
Practice Address - Fax:941-751-9039
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPT2276225100000X
MEAT1352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer