Provider Demographics
NPI:1952839144
Name:KERN, ALLISON M
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:KERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 N ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-1245
Mailing Address - Country:US
Mailing Address - Phone:316-295-2830
Mailing Address - Fax:316-295-2833
Practice Address - Street 1:1443 N ROCK RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1245
Practice Address - Country:US
Practice Address - Phone:316-295-2830
Practice Address - Fax:316-295-2833
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7378122300000X
KS7378122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist