Provider Demographics
NPI:1982179396
Name:KAYE, KERRI L (RN)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:L
Last Name:KAYE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 BIRKMONT DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6407
Mailing Address - Country:US
Mailing Address - Phone:916-294-9013
Mailing Address - Fax:916-294-9024
Practice Address - Street 1:1965 BIRKMONT DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6407
Practice Address - Country:US
Practice Address - Phone:916-294-9013
Practice Address - Fax:916-294-9024
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56891163WS0200X
CA523293163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool