Healthcare Provider Details

I. General information

NPI: 1891562864
Provider Name (Legal Business Name): EMMA KERR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 NEW RD STE 201
LINWOOD NJ
08221-1281
US

IV. Provider business mailing address

6701 W 64TH ST STE 125
OVERLAND PARK KS
66202-4007
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-8593
  • Fax: 609-904-6929
Mailing address:
  • Phone: 913-563-5478
  • Fax: 913-701-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: