Provider Demographics
NPI:1942625439
Name:KERN, STEPHANIE (DC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KERN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 SR 436
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707
Mailing Address - Country:US
Mailing Address - Phone:386-451-5762
Mailing Address - Fax:
Practice Address - Street 1:853 SR 436
Practice Address - Street 2:SUITE 1001
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:386-451-5762
Practice Address - Fax:407-960-3229
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor