Jessica Kerr
Individual provider Active NPI Registered Nurse · Alden, NY
NPI 1689291312 · NPPES record last updated Jun 29, 2020
Key facts
- NPI
- 1689291312
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 745076 (NY)
- Practice address
- 12339 Williston Rd
Alden, NY 14004-9421 - Phone
- (716) 256-9063
- NPI assigned
- Jun 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 745076 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 745076 | NY | Yes |
Addresses
Primary practice location
12339 Williston Rd
Alden, NY 14004-9421
Mailing address
12339 Williston Rd
Alden, NY 14004-9421
Phone (716) 256-9063
Other providers in Alden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.