Provider Demographics
NPI:1932963063
Name:ANDERSON, JERRI ANN (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:JERRI
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:JERRI
Other - Middle Name:ANN
Other - Last Name:STEBBINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2424 SIR BARTON WAY STE 175
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2531
Mailing Address - Country:US
Mailing Address - Phone:859-233-4882
Mailing Address - Fax:
Practice Address - Street 1:2424 SIR BARTON WAY STE 175
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2531
Practice Address - Country:US
Practice Address - Phone:859-233-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1181360163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health