Healthcare Provider Details

I. General information

NPI: 1881954329
Provider Name (Legal Business Name): ANNA E KERSEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 FLORENCE RD
SAVANNAH TN
38372-3451
US

IV. Provider business mailing address

PO BOX 655
SAVANNAH TN
38372-0655
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-2300
  • Fax: 731-925-3506
Mailing address:
  • Phone: 731-925-2300
  • Fax: 731-925-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: