Healthcare Provider Details

I. General information

NPI: 1346163169
Provider Name (Legal Business Name): CESCILLE C KERR PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 W FIESTA KEY LOOP KEY LOOP
DELAND FL
32720-3986
US

IV. Provider business mailing address

218 W FIESTA KEY LOOP KEY LOOP
DELAND FL
32720-3986
US

V. Phone/Fax

Practice location:
  • Phone: 786-419-8405
  • Fax:
Mailing address:
  • Phone: 786-419-8405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN9401290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: