Provider Demographics
NPI:1669932158
Name:KERLIN, ROBERT JAMES
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:KERLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7328 NW 115TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2709
Mailing Address - Country:US
Mailing Address - Phone:405-626-1944
Mailing Address - Fax:
Practice Address - Street 1:7328 NW 115TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-2709
Practice Address - Country:US
Practice Address - Phone:405-626-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician