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General NPI Number Information
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NPI Number | 1013552637
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Entity Type | Individual
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Provider Name | CARRIE LEIGH KERN NP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 11601 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2660
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Country | US
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Telephone | 505-207-3421
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Fax | 505-702-8171
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Provider Business Mailing Address
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Address Line | 2100 SW 119TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-3437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP142648
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-73109
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201995
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License Number State | OK
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