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General NPI Number Information
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NPI Number | 1235215039
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Entity Type | Individual
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Provider Name | KERI REGINA FERSHTMAN CPNP
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3115 COLLEGE PARK DR SUITE 104
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City | CONROE
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State | TX
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Zip | 77384-4001
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Country | US
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Telephone | 936-321-5030
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Fax | 936-271-5033
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Provider Business Mailing Address
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Address Line | 15 CANDLE PINE PL
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City | THE WOODLANDS
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State | TX
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Zip | 77381
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Country | US
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Telephone | 936-321-2195
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 584433
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License Number State | TX
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