Healthcare Provider Details

I. General information

NPI: 1396045258
Provider Name (Legal Business Name): MARY TERESA KERR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY TERESA VICE ARNP

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 PINELLAS ST STE 320
CLEARWATER FL
33756-3369
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-446-2273
  • Fax: 727-441-4966
Mailing address:
  • Phone: 727-532-0002
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11006518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: