Provider Demographics
NPI:1356812309
Name:ANDERSON, KERRY LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:LYNN
Other - Last Name:ORLANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:168 FRANKLIN CORNER RD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2529
Mailing Address - Country:US
Mailing Address - Phone:096-896-0303
Mailing Address - Fax:609-896-0308
Practice Address - Street 1:168 FRANKLIN CORNER RD BLDG 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2529
Practice Address - Country:US
Practice Address - Phone:609-896-0303
Practice Address - Fax:609-896-0308
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00884000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily