Provider Demographics
NPI:1841248762
Name:KERR, KRISTEN JANE (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:JANE
Last Name:KERR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2250
Mailing Address - Country:US
Mailing Address - Phone:717-576-8219
Mailing Address - Fax:717-658-0652
Practice Address - Street 1:890 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 208
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2250
Practice Address - Country:US
Practice Address - Phone:717-576-8219
Practice Address - Fax:717-658-0652
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001518230OtherBLUE SHIELD
PA50025063OtherCAPITAL BLUE CROSS
PA075689Medicare ID - Type Unspecified
PAU98028Medicare UPIN