Provider Demographics
NPI:1265804264
Name:KERR, BETH (CNA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119A NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-6111
Mailing Address - Country:US
Mailing Address - Phone:401-871-4664
Mailing Address - Fax:
Practice Address - Street 1:119A NIAGARA ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-6111
Practice Address - Country:US
Practice Address - Phone:401-871-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINA46284376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide