Provider Demographics
NPI:1245125715
Name:SPEGMAN, KERI LYNNE (BSN)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:LYNNE
Last Name:SPEGMAN
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:LYNNE
Other - Last Name:VAN ROSSUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:475 CHIPPEWA MALL DR STE 418
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5047
Mailing Address - Country:US
Mailing Address - Phone:715-720-3078
Mailing Address - Fax:715-720-2322
Practice Address - Street 1:475 CHIPPEWA MALL DR STE 418
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-5047
Practice Address - Country:US
Practice Address - Phone:715-720-3078
Practice Address - Fax:715-720-2322
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168960-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse