Provider Demographics
NPI:1205977121
Name:WEMMER, KERRIE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:KERRIE
Middle Name:MARIE
Last Name:WEMMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:HALO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:337 N MAIN ST
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4310
Mailing Address - Country:US
Mailing Address - Phone:845-638-4574
Mailing Address - Fax:845-638-9436
Practice Address - Street 1:337 N MAIN ST
Practice Address - Street 2:SUITE 6A
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4310
Practice Address - Country:US
Practice Address - Phone:845-638-4574
Practice Address - Fax:845-638-9436
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily