Healthcare Provider Details

I. General information

NPI: 1972014454
Provider Name (Legal Business Name): MARIKA LENEE KERR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 09/12/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 GRIER DR
LAS VEGAS NV
89119-3791
US

IV. Provider business mailing address

1181 GRIER DR
LAS VEGAS NV
89119-3791
US

V. Phone/Fax

Practice location:
  • Phone: 888-888-9930
  • Fax:
Mailing address:
  • Phone: 888-888-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN002666
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: