Healthcare Provider Details

I. General information

NPI: 1225216195
Provider Name (Legal Business Name): KERRY HERRMANN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRY DORFFNER AU.D.

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WILLOW VALLEY LAKES DR
WILLOW STREET PA
17584-9442
US

IV. Provider business mailing address

300 WILLOW VALLEY LAKES DR
WILLOW STREET PA
17584-9442
US

V. Phone/Fax

Practice location:
  • Phone: 717-464-6411
  • Fax: 223-307-4060
Mailing address:
  • Phone: 717-464-6411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number020000171
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00073300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00111900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number030000231
License Number StateDE
# 5
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006021
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: