Healthcare Provider Details

I. General information

NPI: 1053121376
Provider Name (Legal Business Name): SHERRI LYNNE KERR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 ROYAL AVE
SPIRIT LAKE IA
51360-1190
US

IV. Provider business mailing address

1850 ROYAL AVE
SPIRIT LAKE IA
51360-1190
US

V. Phone/Fax

Practice location:
  • Phone: 712-336-6404
  • Fax: 612-725-1098
Mailing address:
  • Phone: 712-336-6404
  • Fax: 612-725-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number114527
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: