Provider Demographics
NPI:1821635582
Name:STERNE, KERRY COLLEEN (PT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:COLLEEN
Last Name:STERNE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:COLLEEN
Other - Last Name:BEECHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:722 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGFISHER
Mailing Address - State:OK
Mailing Address - Zip Code:73750-3623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:722 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-3623
Practice Address - Country:US
Practice Address - Phone:405-885-6271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist