Provider Demographics
NPI:1821619909
Name:MUNESES, KERRY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ANN
Last Name:MUNESES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KERRY
Other - Middle Name:ANN
Other - Last Name:MCAULIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10324A BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2128
Mailing Address - Country:US
Mailing Address - Phone:410-707-2040
Mailing Address - Fax:410-418-4009
Practice Address - Street 1:10324A BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2128
Practice Address - Country:US
Practice Address - Phone:410-707-2040
Practice Address - Fax:410-418-4009
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor