Provider Demographics
NPI:1770871634
Name:ROBERTSON, KERRI SULLIVAN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:SULLIVAN
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 7TH PL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3801
Mailing Address - Country:US
Mailing Address - Phone:561-969-6663
Mailing Address - Fax:
Practice Address - Street 1:7240 7TH PL N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3801
Practice Address - Country:US
Practice Address - Phone:561-969-6663
Practice Address - Fax:561-721-3106
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9168981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily