Provider Demographics
NPI:1841620820
Name:KERNAN, MEGHANN
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:
Last Name:KERNAN
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 1:5909 NORTHWOOD LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-1562
Mailing Address - Country:US
Mailing Address - Phone:205-394-4337
Mailing Address - Fax:
Practice Address - Street 1:815 27TH AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2119
Practice Address - Country:US
Practice Address - Phone:205-394-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst