Provider Demographics
NPI:1801558838
Name:KERNS, CHRISTINE ANNETTE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNETTE
Last Name:KERNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 MCVICKER RD
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-7004
Mailing Address - Country:US
Mailing Address - Phone:304-841-5911
Mailing Address - Fax:
Practice Address - Street 1:1672 MCVICKER RD
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-7004
Practice Address - Country:US
Practice Address - Phone:304-841-5911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV47508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse