MEDICARE: KERI ALFORD HEALTH EDUCATOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133NN1002X	Nutrition Education Nutritionist
2	171400000X	Health & Wellness Coach
3	174H00000X	Health Educator

General Provider Information

NPI Number	:	1912716937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI ALFORD HEALTH EDUCATOR

Provider Business Mailing Address
First Line	:	2764 PLEASANT ROAD
Second Line	:	SUITE A- UNIT 10103
City	:	FORT MILL
State	:	SC
Zip	:	29708-7020
Country	:	US
Telephone Number	:	917-270-0391
Fax Number	:

Provider Business Practice Location Address
First Line	:	14109 RIDGEWATER WAY
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-7020
Country	:	US
Telephone Number	:	917-270-0391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2025
Last Update Date	:	01/03/2025

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Directions to “ KERI ALFORD HEALTH EDUCATOR” Practice Location

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