Provider Demographics
NPI:1881324085
Name:ADAMS, KERILYNN (MA)
Entity type:Individual
Prefix:
First Name:KERILYNN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 26TH ST NW APT 8
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-4120
Mailing Address - Country:US
Mailing Address - Phone:949-231-8804
Mailing Address - Fax:
Practice Address - Street 1:3000 ERIE ST S
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7976
Practice Address - Country:US
Practice Address - Phone:330-833-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty