Provider Demographics
NPI:1952416760
Name:SUTER, KERRI R
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:R
Last Name:SUTER
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 1:2016 DRAKES HILL CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-8845
Mailing Address - Country:US
Mailing Address - Phone:615-673-6737
Mailing Address - Fax:615-296-4567
Practice Address - Street 1:438 N WATER AVE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2306
Practice Address - Country:US
Practice Address - Phone:615-673-6737
Practice Address - Fax:615-296-4567
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN APN 8321363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3666265Medicare PIN
TN103I508599Medicare UPIN