Provider Demographics
NPI:1255346995
Name:HUSMAN, KERRI J (MD)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:J
Last Name:HUSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E COLLEGE ST STE 211
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1759
Mailing Address - Country:US
Mailing Address - Phone:866-425-8066
Mailing Address - Fax:
Practice Address - Street 1:221 E COLLEGE ST STE 211
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1759
Practice Address - Country:US
Practice Address - Phone:319-365-3993
Practice Address - Fax:319-364-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA328222084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1192781Medicaid
IA13455Medicare ID - Type Unspecified
IA1192781Medicaid