Provider Demographics
NPI:1851541023
Name:KERBY, MICHELLE (OTR)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KERBY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:NATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:5206 COVESOUND WAY
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5206 COVESOUND WAY
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3328
Practice Address - Country:US
Practice Address - Phone:813-502-1794
Practice Address - Fax:877-814-9122
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60028677174400000X
FLOT23178225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174400000XOther Service ProvidersSpecialist