Provider Demographics
NPI:1255702064
Name:RASSI, KERI KATHLEEN (ARNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:KATHLEEN
Last Name:RASSI
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730875
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32173-0875
Mailing Address - Country:US
Mailing Address - Phone:386-631-5675
Mailing Address - Fax:866-728-2444
Practice Address - Street 1:712 S OCEAN SHORE BLVD STE 107
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-3602
Practice Address - Country:US
Practice Address - Phone:386-631-5675
Practice Address - Fax:866-728-2444
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9262606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily